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Individual

STEPHEN PATRICK EDWARDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O. D.

Contact information

Practice address
302 RAILROAD ST, WATER VALLEY, MS 38965-3032
(662) 473-2181
(662) 473-2161
Mailing address
130 W VAN DORN AVE, HOLLY SPRINGS, MS 38635-2902
(662) 252-3323
(662) 252-5858

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
544
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00880206
MS
Enumeration date
09/20/2006
Last updated
01/04/2017
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