Individual
PHILIP WAYNE MARLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
201 HWY 16 E, CARTHAGE, MS 39051
(601) 267-9351
(601) 267-9004
Mailing address
PO BOX 911, CARTHAGE, MS 39051-0911
(601) 267-9351
(601) 267-9004
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
605
MS
152WC0802X
Corneal and Contact Management Optometrist
605
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00880054
—
MS
01
—
5196240001
DMERC NUMBER
MS
01
—
P00079224
RAILROAD MEDICARE
MS
Enumeration date
08/19/2005
Last updated
01/06/2011
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