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
Update your record
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