Organization
OLIVE BRANCH EYECARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID LLOYD PARKER O.D. (MEMBER)
(662) 893-3300
Entity
Organization
Contact information
Practice address
6947 CRUMPLER BLVD, SUITE 100, OLIVE BRANCH, MS 38654-1922
(662) 893-3300
Mailing address
6947 CRUMPLER BLVD, SUITE 100, OLIVE BRANCH, MS 38654-1922
(662) 893-3300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09577062
—
MS
01
—
DG2594
RAILROAD MEDICARE PIN
—
Enumeration date
06/07/2007
Last updated
09/19/2008
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