Organization
OBREINEYECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID V OBRIEN OD (OWNER)
(662) 647-8707
Entity
Organization
Contact information
Practice address
354 STATELINE RD W, SOUTHAVEN, MS 38671-1610
(662) 647-8707
(662) 647-8706
Mailing address
354 STATELINE RD W, SOUTHAVEN, MS 38671-1610
(662) 647-8707
(662) 647-8706
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
426
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087700
—
MS
Enumeration date
12/05/2006
Last updated
12/11/2007
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