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Organization

EYE LASER & SURGERY CENTER OF COLUMBUS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. RENEE OWEN R.N. (CLINICAL DIRECTOR)
(662) 327-3773
Entity
Organization

Contact information

Practice address
634 LEIGH DR, COLUMBUS, MS 39705-3014
(662) 327-3773
(662) 327-3996
Mailing address
634 LEIGH DR, COLUMBUS, MS 39705-3014
(662) 327-3773
(662) 327-3996

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00770586
MS
Enumeration date
10/07/2005
Last updated
07/20/2007
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