Healthcare Provider Details
I. General information
NPI: 1477421436
Provider Name (Legal Business Name): HOLLY SPRINGS EYECARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/29/2025
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1028 N MISSOURI ST STE 1
WEST MEMPHIS AR
72301-2600
US
IV. Provider business mailing address
640 J M ASH DR
HOLLY SPRINGS MS
38635-3401
US
V. Phone/Fax
- Phone: 870-735-8466
- Fax: 870-735-0717
- Phone: 662-473-2181
- Fax: 662-473-2161
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHEN
PATRICK
EDWARDS
Title or Position: OWNER
Credential: OD
Phone: 662-473-2181