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Organization

SHAPPLEY EYE CLINIC PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT W SHAPPLEY (OWNER-MANAGER)
(662) 286-6171
Entity
Organization

Contact information

Practice address
804 CHILDS ST, CORINTH, MS 38834-4933
(662) 286-6171
(662) 287-3937
Mailing address
804 CHILDS ST, CORINTH, MS 38834-4933
(662) 286-6171
(662) 287-3937

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
542
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09015503
MS
01
168727
EYEMED
MS
01
18147
SPECTERA
MS
01
410044588
RAILROAD MEDICARE
MS
01
425233202A
BLUE CROSS BLUE SHIELD
MS
01
57711
DAVIS VISION
MS
Enumeration date
04/23/2007
Last updated
02/11/2009
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