Organization
COLLINS EYE CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
C. CHRIS COLLINS OD (PRESIDENT)
(601) 638-2081
Entity
Organization
Contact information
Practice address
1206 MISSION 66, VICKSBURG, MS 39183-3137
(601) 638-2081
(601) 638-2171
Mailing address
1206 MISSION 66, VICKSBURG, MS 39183-3137
(601) 638-2081
(601) 638-2171
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
522
MS
332H00000X
Eyewear Supplier
522
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087003
—
MS
Enumeration date
05/06/2008
Last updated
11/17/2011
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