Organization
CHARLESTON VISION CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEIGH TACKETT (CLINIC COORDINATOR)
(662) 647-8707
Entity
Organization
Contact information
Practice address
288 W MAIN ST, CHARLESTON, MS 38921-2229
(662) 647-8707
(662) 647-8706
Mailing address
1890 GOODMAN RD E, SUITE 100, SOUTHAVEN, MS 38671-9504
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
722
MS
152W00000X
Optometrist
Primary
—
MS
Other
Enumeration date
03/13/2013
Last updated
02/01/2021
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