Healthcare Provider Details

I. General information

NPI: 1205634037
Provider Name (Legal Business Name): MS EYE SURGERY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1622 HIGHWAY 30 E
OXFORD MS
38655-2319
US

IV. Provider business mailing address

1622 HIGHWAY 30 E
OXFORD MS
38655-2319
US

V. Phone/Fax

Practice location:
  • Phone: 901-387-9650
  • Fax:
Mailing address:
  • Phone: 667-371-1952
  • Fax: 662-371-0499

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: JAMES BYRON SHIPP
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 662-234-3937