Organization
ENVISION EYE CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYATTA T. HAIRSTON O.D. (OWNER)
(601) 987-3937
Entity
Organization
Contact information
Practice address
1625 SIMPSON HWY 49, MAGEE, MS 39111
(601) 849-2822
(601) 849-5334
Mailing address
1625 SIMPSON HWY 49, MAGEE, MS 39111
(601) 849-2822
(601) 849-5334
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
658
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05254312
—
MS
Enumeration date
05/15/2007
Last updated
07/08/2011
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