Organization
MEDICAL PLAZA EYE CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WOODY D DAVIS M.D. (PRESIDENT)
(601) 483-7331
Entity
Organization
Contact information
Practice address
5002 HWY 39 N, BLDG B, MERIDIAN, MS 39301-1078
(601) 483-7331
(601) 483-3721
Mailing address
5002 HWY 39 N, BLDG B, MERIDIAN, MS 39301-1078
(601) 483-7331
(601) 483-3721
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
05260
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13247
—
MS
01
—
8525
MEDICAID AL
AL
Enumeration date
04/08/2008
Last updated
08/20/2008
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