Organization
ADVANCED EYECARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRAIG MICHEAL STASNEY O.D. (OPTOMETRIST)
(601) 799-0707
Entity
Organization
Contact information
Practice address
5 ALEX PL, PICAYUNE, MS 39466-9697
(601) 799-0707
(601) 799-0700
Mailing address
5 ALEX PL, PICAYUNE, MS 39466-9697
(601) 799-0707
(601) 799-0700
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
611
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05152521
—
MS
Enumeration date
04/24/2007
Last updated
12/13/2017
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