Individual
GLEN H STRIBLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
110 E GEORGETOWN ST, CRYSTAL SPRINGS, MS 39059-2746
(601) 892-5053
(601) 892-5741
Mailing address
110 E GEORGETOWN ST, CRYSTAL SPRINGS, MS 39059-2746
(601) 892-5053
(601) 892-5741
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
516
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087004
—
MS
01
—
410044093
MEDICARE RAILROAD
MS
Enumeration date
11/03/2005
Last updated
12/07/2023
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