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Individual

PAMELA DIANE THARP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
6351 INTERSTATE 55 NORTH,, STE. 115-B, JACKSON, MS 39213
(601) 991-9723
(601) 991-9745
Mailing address
6351 INTERSTATE 55 NORTH,, STE. 115-B, JACKSON, MS 39213
(601) 991-9723
(601) 991-9745

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
618
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00880103
MS
Enumeration date
11/17/2006
Last updated
07/16/2010
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