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Organization

MS EYE CARE PA

Active
Parent organization
MS EYE CARE PA
Other names
NOXUBEE EYE CARE
Organization subpart
Yes

Provider details

NPI number
Legal business name
MS EYE CARE PA
Authorized official
TAMMY WOMBLE (CREDENTIALING)
(662) 446-9000
Entity
Organization

Contact information

Practice address
3027 JEFFERSON ST, MACON, MS 39341-2275
(662) 726-6111
(662) 726-6110
Mailing address
PO BOX 826, PHILADELPHIA, MS 39350-0826
(662) 446-9000
(662) 779-4030

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
517
MS
152W00000X
Optometrist
560
MS
152W00000X
Optometrist
762
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05208871
MS
Enumeration date
08/16/2006
Last updated
05/24/2022
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