Organization
GRADY M. CLARK JR., O.D.P.A.
Active
Other names
Eyetech Eyecare Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WENDY K CLARK (OFFICE ADMINISTRATOR)
(601) 693-2020
Entity
Organization
Contact information
Practice address
2112 N FRONTAGE RD, MERIDIAN, MS 39301-6158
(601) 693-2020
(601) 693-2690
Mailing address
2112 N FRONTAGE RD, MERIDIAN, MS 39301-6158
(601) 693-2020
(601) 693-2690
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
457
MS
Other
Enumeration date
09/08/2014
Last updated
02/20/2017
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