Organization
VITREORETINAL EYE CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AVIT J GREMILLION MD (PRESIDENT/OWNER)
(228) 388-7000
Entity
Organization
Contact information
Practice address
962 TOMMY MUNRO DR STE E, BILOXI, MS 39532-2139
(228) 388-7000
(833) 849-9899
Mailing address
962 TOMMY MUNRO DR STE E, BILOXI, MS 39532-2139
(228) 388-7000
(833) 849-9899
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
—
—
261QM2500X
Medical Specialty Clinic/Center
023984
LA
261QM2500X
Medical Specialty Clinic/Center
Primary
17239
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05109745
—
MS
05
—
08623204
—
MS
05
—
1486787
—
LA
01
—
438354140A
LA BCBS
LA
01
—
438354140B
BLUE CROSS BLUE SHIELD MS
MS
01
—
7812033
AETNA
MS
01
—
DE8313
MEDICARE RAILROAD
MS
Enumeration date
01/12/2007
Last updated
12/05/2023
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