Organization
INDIANOLA EYE CLINIC PA
Active
Other names
Delta Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILBURN LORD O.D. (PRESIDENT)
(662) 332-0163
Entity
Organization
Contact information
Practice address
224 VIRGINIA ST, INDIANOLA, MS 38751-2221
(662) 887-3671
(662) 887-3675
Mailing address
239 S. WASHINGTON AVE., GREENVILLE, MS 38704
(662) 332-0163
(662) 378-3394
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
460
MS
Other
Enumeration date
05/15/2008
Last updated
05/15/2008
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