Organization
MADISON PROFESSIONAL EYECARE ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON WALLEY O.D. (OWNER)
(601) 605-2259
Entity
Organization
Contact information
Practice address
224 WATERFORD SQ, MADISON, MS 39110-6856
(601) 605-2259
(601) 856-0195
Mailing address
224 WATERFORD SQ, MADISON, MS 39110-8409
(601) 605-2259
(601) 856-0195
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
MS
Other
Enumeration date
10/24/2006
Last updated
09/10/2014
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