Organization
ABERDEEN EYE CLINIC P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY CONSTANCE LONG O.D. (PRESIDENT)
(662) 369-2444
Entity
Organization
Contact information
Practice address
114 N HICKORY ST, ABERDEEN, MS 39730-2648
(662) 369-2444
(662) 369-7223
Mailing address
PO BOX 955, ABERDEEN, MS 39730-0955
(662) 369-2444
(662) 369-7223
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
490
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00822765
—
MS
Enumeration date
06/19/2006
Last updated
07/31/2009
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