Organization
SANDERS EYE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY J SANDERS MD (MEDICAL DOCTOR)
(601) 684-0220
Entity
Organization
Contact information
Practice address
822 DELAWARE AVE, MCCOMB, MS 39648-3824
(601) 684-0220
(601) 684-5573
Mailing address
822 DELAWARE AVE, MCCOMB, MS 39648-3824
(601) 684-0220
(601) 684-5573
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
18847
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08172021
MEDICAID-CLINIC
MS
01
—
180000373
MEDICARE-CLINIC
MS
Enumeration date
10/16/2006
Last updated
03/25/2008
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