Organization
OPHTHALMIC PLASTIC SURGERY SPECIALISTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID RONALD SEGREST MD (OWNER)
(601) 355-9537
Entity
Organization
Contact information
Practice address
1421 NORTH STATE ST, STE 304, JACKSON, MS 39202
(601) 355-9537
(601) 355-6893
Mailing address
1421 NORTH STATE ST, STE 304, JACKSON, MS 39202
(601) 355-9537
(601) 355-6893
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00580070
—
MS
01
—
DC7890
RAILROAD MEDICARE
—
Enumeration date
09/22/2006
Last updated
03/24/2010
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