Organization
SHAFFER EYE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CURTIS J SHAFFER O.D. (OWNER)
(601) 428-4420
Entity
Organization
Contact information
Practice address
5203 HIGHWAY 11 N, ELLISVILLE, MS 39437-5001
(601) 428-4420
(601) 425-9018
Mailing address
5203 HIGHWAY 11 N, ELLISVILLE, MS 39437-5001
(601) 428-4420
(601) 425-9018
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
695
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016268
—
MS
Enumeration date
04/09/2008
Last updated
04/09/2008
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