Healthcare Provider Details

I. General information

NPI: 1891951885
Provider Name (Legal Business Name): MISSISSIPPI EYE SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2008
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3434 BIENVILLE BLVD
OCEAN SPRINGS MS
39564-5732
US

IV. Provider business mailing address

3434 BIENVILLE BLVD
OCEAN SPRINGS MS
39564-5732
US

V. Phone/Fax

Practice location:
  • Phone: 228-244-0067
  • Fax: 228-818-0519
Mailing address:
  • Phone: 228-244-0067
  • Fax: 228-818-0519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. FRANKLIN RAWLINGS
Title or Position: PRESIDENT
Credential: MD
Phone: 228-818-0563