# EYE CLINIC OF MERIDIAN PLLC

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

## Provider details

- **NPI number:** 1942285564
- **Authorized official:** DR. DON E MARASCALCO MD (SENIOR PARTNER)
- **Authorized official phone:** (601) 485-2368

## Contact information

- **Practice address:** 1301 20TH AVE, MERIDIAN, MS 39301-4121
- **Practice address phone:** (601) 485-2368
- **Practice address fax:** (601) 693-2174
- **Mailing address:** PO BOX 1551, MERIDIAN, MS 39302-1551
- **Mailing address phone:** (601) 485-2368
- **Mailing address fax:** (601) 693-2174

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/07/2005
- **Last updated:** 05/19/2008

## 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 |