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Organization

TAYLORSVILLE EYE CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TAMMY WOMBLE (INSURANCE)
(601) 785-0111
Entity
Organization

Contact information

Practice address
300 PINE ST, TAYLORSVILLE, MS 39168-5432
(601) 785-0111
Mailing address
PO BOX 1280, TAYLORSVILLE, MS 39168-1280

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07927516
MS
Enumeration date
07/24/2012
Last updated
06/13/2013
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