# SHAFFER EYE CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851564017
- **Authorized official:** DR. CURTIS J SHAFFER O.D. (OWNER)
- **Authorized official phone:** (601) 428-4420

## Contact information

- **Practice address:** 5203 HIGHWAY 11 N, ELLISVILLE, MS 39437-5001
- **Practice address phone:** (601) 428-4420
- **Practice address fax:** (601) 425-9018
- **Mailing address:** 5203 HIGHWAY 11 N, ELLISVILLE, MS 39437-5001
- **Mailing address phone:** (601) 428-4420
- **Mailing address fax:** (601) 425-9018

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 695 | MS | Yes |

## Other

- **Enumeration date:** 04/09/2008
- **Last updated:** 04/09/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 09016268 | — | MS |