Organization
THE VISION CLINIC OF VICKSBURG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM SAMUEL ASHLEY O.D. (OWNER/PRESIDENT)
(601) 636-6364
Entity
Organization
Contact information
Practice address
1808 MISSION 66, VICKSBURG, MS 39180-3710
(601) 636-6364
(601) 636-1162
Mailing address
1808 MISSION 66, VICKSBURG, MS 39180-3710
(601) 636-6364
(601) 636-1162
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
487
MS
332H00000X
Eyewear Supplier
487
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087909
—
MS
Enumeration date
08/30/2006
Last updated
07/12/2023
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