Organization
COLUMBUS EYE CLINIC & LASER SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT T BRADLEY M.D. (VICE PRESIDENT)
(662) 328-2061
Entity
Organization
Contact information
Practice address
425 HOSPITAL DR, SUIT 8, COLUMBUS, MS 39705-1901
(662) 328-2061
Mailing address
706 HIGHWAY 12 W # F, STARKVILLE, MS 39759-3573
(662) 328-2061
(662) 328-5000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00485369
—
MS
Enumeration date
04/20/2007
Last updated
08/22/2020
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