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Organization

CROSSROAD EYE CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DARWIN B WOOTEN M.D. (OWNER/PHYSICIAN)
(662) 286-9292
Entity
Organization

Contact information

Practice address
3035 CORDER DR, CORINTH, MS 38834-6216
(662) 286-9292
(662) 286-9293
Mailing address
3035 CORDER DR, PO BOX 1740, CORINTH, MS 38834-6216
(662) 286-9292
(662) 286-9293

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
16628
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00122436
MS
05
01087285
MS
Enumeration date
07/25/2006
Last updated
03/18/2008
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