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Organization

MS EYE CARE PA

Active
Parent organization
MS EYE CARE PA
Other names
MISSISSIPPI EYE CARE STARKVILLE
Organization subpart
Yes

Provider details

NPI number
Legal business name
MS EYE CARE PA
Authorized official
TAMMY WOMBLE (CREDENTIALING)
(662) 446-9000
Entity
Organization

Contact information

Practice address
6 PROFESSIONAL PLZ, STARKVILLE, MS 39759
(662) 323-3330
(662) 323-3880
Mailing address
14994 W MAIN ST, LOUISVILLE, MS 39339-2616
(662) 773-3494
(662) 773-7883

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
492
MS
152W00000X
Optometrist
Primary
706
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05208871
MS
Enumeration date
05/09/2007
Last updated
05/24/2022
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