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Organization

MADISON EYE CARE CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CASSANDRA LEIGH CLEMENTS O.D. (OPTOMETRY)
(601) 605-9885
Entity
Organization

Contact information

Practice address
2168 MAIN ST, SUITE A, MADISON, MS 39110-6319
(601) 605-9885
(601) 605-9815
Mailing address
2168 MAIN ST, SUITE A, MADISON, MS 39110-6319
(601) 605-9885
(601) 605-9815

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
641
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00880188
MS
01
PALMETTO GBA
P00059148
MS
Enumeration date
10/05/2006
Last updated
08/22/2020
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