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Organization
EYE CLINIC OF MERIDIAN PLLC
Active
Organization
EYE CLINIC OF MERIDIAN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DON E MARASCALCO MD (SENIOR PARTNER)
(601) 485-2368
Entity
Organization
Contact information
Practice address
1301 20TH AVE, MERIDIAN, MS 39301-4121
(601) 485-2368
(601) 693-2174
Mailing address
PO BOX 1551, MERIDIAN, MS 39302-1551
(601) 485-2368
(601) 693-2174
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116589
—
MS
05
—
00116642
—
MS
05
—
00880212
—
MS
05
—
009943235
—
AL
05
—
051550436
—
AL
05
—
051550437
—
AL
01
—
051554358
DR JOHNSON-RR MEDICARE
AL
01
—
180041975
DR MASON-RR MEDICARE
AL
01
—
180041976
DR MARASCALCO-RR MEDICARE
AL
Enumeration date
12/07/2005
Last updated
05/19/2008
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