Organization
HAZLEHURST EYE CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD P SMITH O.D. (PRESIDENT)
(601) 894-2951
Entity
Organization
Contact information
Practice address
118 CALDWELL DR, HAZLEHURST, MS 39083-3023
(601) 894-2951
(601) 894-2952
Mailing address
118 CALDWELL DR, HAZLEHURST, MS 39083-3023
(601) 894-2951
(601) 894-2952
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
787
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01081512
—
MS
Enumeration date
07/14/2008
Last updated
08/26/2008
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