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Individual

DR. CHARLES EDWIN MCMASTERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OPTOMETRIST

Contact information

Practice address
120 PROMENADE BLVD, FLOWOOD, MS 39232-8017
(601) 992-1010
(601) 992-7700
Mailing address
120 PROMENADE BLVD, FLOWOOD, MS 39232-8017
(601) 992-1010
(601) 992-7700

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
3504
TX
152W00000X
Optometrist
Primary
530
MS
152W00000X
Optometrist
997
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
08277878
MS
01
410048020
RR MEDICARE
MS
01
5539
DAVIS VISION
MS
01
640935907A
NISSAN, BCBS OF TENN.
MS
Enumeration date
07/18/2006
Last updated
09/12/2016
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