Organization
COCCIA VISION CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS RYAN COCCIA O.D. (PRESIDENT)
(662) 488-9021
Entity
Organization
Contact information
Practice address
100 MCCORD ROAD, PONTOTOC, MS 38863
(662) 488-9021
(662) 488-9022
Mailing address
103 SCENIC CV, SALTILLO, MS 38866-7950
(662) 648-9285
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
739
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04775008
—
MS
01
—
42631
SPECTERA
MS
01
—
54185
DAVIS VISION
MS
01
—
MS0739
EYEMED
MS
Enumeration date
01/19/2007
Last updated
10/27/2010
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