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Organization

THE EYE CLINIC PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM C SAMS III M.D. (PRESIDENT)
(228) 864-2633
Entity
Organization

Contact information

Practice address
1900 23RD AVE, GULFPORT, MS 39501-2965
(228) 864-2633
(228) 865-0339
Mailing address
PO BOX 148, GULFPORT, MS 39502-0148
(228) 864-2633
(228) 865-0339

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
207W00000X
Ophthalmology Physician
332H00000X
Eyewear Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09013545
MS
Enumeration date
05/20/2006
Last updated
04/05/2022
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