Organization
MASSACHUSETTS SOUTH EASTERN EYE CENTER, INC.
Active
Parent organization
MASSACHUSETTS SOUTH EASTERN EYE CENTER, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MASSACHUSETTS SOUTH EASTERN EYE CENTER, INC
Authorized official
CHARLES C WHITE JR. M.D. (OPHTHALMOLOGIST)
(508) 295-3193
Entity
Organization
Contact information
Practice address
40 CHURCH AVE, SUITE 201, WAREHAM, MA 02571-2093
(508) 295-3193
(508) 295-4635
Mailing address
40 CHURCH ST AVENUE, SUITE 201, WAREHAM, MA 02571-2093
(508) 295-3193
(508) 295-4635
Taxonomy
Speciality
Code
Description
License number
State
156FX1100X
Ophthalmic Technician/Technologist
Primary
—
MA
174400000X
Specialist
53631
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110071159A
—
MA
01
—
715421
TUFTS HEALTHCARE
MA
05
—
9758178
—
MA
Enumeration date
07/12/2007
Last updated
02/19/2013
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