Organization
PROFESSIONAL OPTICAL OF MISSISSIPPI INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARRIS C ANTHONY OPTICIAN (OWNER)
(601) 636-5541
Entity
Organization
Contact information
Practice address
1208 MISSION 66, VICKSBURG, MS 39183-3137
(601) 636-5541
Mailing address
1208 MISSION 66, VICKSBURG, MS 39183-3137
(601) 636-5541
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00880167
—
MS
Enumeration date
10/12/2007
Last updated
01/11/2008
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