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NPI Code Detail

MEDICARE: UNIVERSITY OPHTHALMOLOGY ASSOCIATES

MEDICARE: UNIVERSITY OPHTHALMOLOGY ASSOCIATES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician08640MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477556231
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSITY OPHTHALMOLOGY ASSOCIATES
Provider Business Mailing Address
First Line : 2500 N STATE ST
Second Line : STE B329
City : JACKSON
State : MS
Zip : 39216-4500
Country : US
Telephone Number : 601-815-3931
Fax Number : 601-815-3773
Provider Business Practice Location Address
First Line : 2500 N STATE ST
Second Line : STE B329
City : JACKSON
State : MS
Zip : 39216-4500
Country : US
Telephone Number : 601-815-3931
Fax Number : 601-815-3773
Authorized Official
Title or Position : MANAGING PARTNER
Name : CHING JYGH CHEN
Credential : M. D.
Telephone Number : 601-984-5022
Provider Enumeration Date : 05/24/2005
Last Update Date : 09/09/2009

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Directions to “UNIVERSITY OPHTHALMOLOGY ASSOCIATES ” Practice Location

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