Individual
DR. CARL J MARASCALCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
600 OLD HICKORY RD, GRENADA, MS 38901-2727
(662) 226-7010
(662) 226-7027
Mailing address
600 OLD HICKORY RD, GRENADA, MS 38901-2727
(662) 226-7010
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
504
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087926
—
MS
Enumeration date
10/18/2006
Last updated
08/01/2008
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