Organization
NEWMAN EYE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES STANTON NEWMAN JR. O.D. (OPTOMETRIST)
(228) 467-1020
Entity
Organization
Contact information
Practice address
299 HIGHWAY 90, BAY ST LOUIS, MS 39520-3606
(228) 467-1020
(228) 467-7258
Mailing address
299 HIGHWAY 90, BAY ST LOUIS, MS 39520-3606
(228) 467-1020
(228) 467-7258
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
524
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00087081
MEDICAID SERVICE PROVIDER
MS
01
—
0830067/426083155-00
UNITEDHEALTHCARE
MS
01
—
410046800
RAILROAD MEDICARE
—
01
—
426083155C
BLUECROSSBLUESHIELD
MS
01
—
5727622
AETNA
MS
05
—
9013468
—
MS
Enumeration date
02/12/2008
Last updated
02/12/2008
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