Individual
DR. GLENN GOLDRING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
106 E MAIN ST, SENATOBIA, MS 38668-2138
(662) 562-5500
(662) 562-0600
Mailing address
106 E MAIN ST, SENATOBIA, MS 38668-2138
(662) 562-5500
(662) 562-0600
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
673
TN
152WC0802X
Corneal and Contact Management Optometrist
Primary
468
MS
152WC0802X
Corneal and Contact Management Optometrist
673
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087885
—
MS
01
—
64-0616130
HUMANA GOLD CHOICE
MS
Enumeration date
07/18/2006
Last updated
01/31/2019
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