Organization
MS EYE CARE PA
Active
Parent organization
MS EYE CARE PA
Other names
MISSISSIPPI EYE CARE LOUISVILLE
Organization subpart
Yes
Provider details
NPI number
Legal business name
MS EYE CARE PA
Authorized official
TAMMY WOMBLE (CREDENTIALING)
(624) 446-9000
Entity
Organization
Contact information
Practice address
14994 W MAIN ST, LOUISVILLE, MS 39339-2616
(662) 773-3494
(662) 773-7883
Mailing address
14994 W MAIN ST, LOUISVILLE, MS 39339-2616
(662) 773-3494
(662) 773-7883
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05208871
—
MS
Enumeration date
08/12/2006
Last updated
05/24/2022
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