Organization
PROFESSIONAL EYECARE ASSOCIATES ,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL J PHILLIPS O.D. (OWNER)
(601) 957-9292
Entity
Organization
Contact information
Practice address
6704 OLD CANTON RD, RIDGELAND, MS 39157-1225
(601) 957-9292
(601) 957-7585
Mailing address
6704 OLD CANTON RD, RIDGELAND, MS 39157-1225
(601) 957-9292
(601) 957-7585
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03950565
—
MS
Enumeration date
10/25/2006
Last updated
09/16/2014
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