Healthcare Provider Details
I. General information
NPI: 1407784077
Provider Name (Legal Business Name): OLIVE BRANCH VISION SPECIALISTS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8863 GOODMAN RD
OLIVE BRANCH MS
38654-2203
US
IV. Provider business mailing address
2553 WOODHURST CV
GERMANTOWN TN
38139-6825
US
V. Phone/Fax
- Phone: 662-367-2438
- Fax:
- Phone: 901-871-2373
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SETH
L
YOSER
Title or Position: PROVIDER/OWNER
Credential:
Phone: 901-871-2373