Healthcare Provider Details

I. General information

NPI: 1053743781
Provider Name (Legal Business Name): ROGERS FAMILY EYE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2013
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HIGHLAND COLONY PKWY STE 9007
RIDGELAND MS
39157-2083
US

IV. Provider business mailing address

1000 HIGHLAND COLONY PKWY STE 9007
RIDGELAND MS
39157-2083
US

V. Phone/Fax

Practice location:
  • Phone: 601-957-6078
  • Fax: 601-957-6924
Mailing address:
  • Phone: 601-957-6078
  • Fax: 601-957-6924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number875
License Number StateMS

VIII. Authorized Official

Name: DR. BRITTANY NICOLE ROGERS
Title or Position: DOCTOR OF OPTOMETRY
Credential: OD
Phone: 662-587-1926