Individual
MICHAEL BIFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
726 GOODMAN RD E STE B, SOUTHAVEN, MS 38671-9530
(662) 349-1959
(662) 510-2391
Mailing address
726 GOODMAN RD E STE B, SOUTHAVEN, MS 38671-9530
(662) 349-1959
(662) 510-2391
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1094
MS
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/24/2024
Last updated
08/19/2025
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