Organization
PREMIER EYE CLINIC , PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN K SPENCER O.D. (CO-OWNER)
(228) 762-1525
Entity
Organization
Contact information
Practice address
4505 HOSPITAL ST STE A, PASCAGOULA, MS 39581-5302
(228) 762-1525
(228) 769-2635
Mailing address
4505 HOSPITAL ST STE A, PASCAGOULA, MS 39581-5302
(228) 762-1525
(228) 769-2635
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
526 AND 653
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0087006
—
MS
05
—
00880168
—
MS
Enumeration date
11/01/2006
Last updated
08/22/2020
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