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Organization

OBRIEN VISION CENTER, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL EDWARD OBRIEN O.D. (PRESIDENT)
(662) 772-5882
Entity
Organization

Contact information

Practice address
1890 GOODMAN RD E, SUITE 100, SOUTHAVEN, MS 38671-9552
(662) 772-5882
(662) 772-5808
Mailing address
1890 GOODMAN RD E, SUITE 100, SOUTHAVEN, MS 38671-9552
(662) 772-5882
(662) 772-5808

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
593
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00880166
MS
Enumeration date
11/03/2006
Last updated
04/11/2013
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