Organization
RAGAN FAMILY EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY J RAGAN O.D. (OWNER)
(601) 853-7640
Entity
Organization
Contact information
Practice address
127 GRANDVIEW DR, MADISON, MS 39110-7595
(601) 853-7640
(601) 853-7614
Mailing address
PO BOX 2150, MADISON, MS 39130-2150
(601) 853-7640
(601) 853-7614
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
727
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04937040
—
MS
01
—
WALM45096
SPECTERA
MS
Enumeration date
09/29/2006
Last updated
07/26/2011
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