Organization
CLEVELAND EYE CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMMETT DONALD SMITH (PRESIDENT)
(662) 846-6641
Entity
Organization
Contact information
Practice address
136 NORTH STREET, CLEVELAND, MS 38732
(662) 846-6641
(662) 846-6644
Mailing address
PO BOX 1108, CLEVELAND, MS 38732
(662) 846-6641
(662) 846-6644
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
546
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09957099
—
MS
Enumeration date
11/07/2006
Last updated
03/18/2008
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