Healthcare Provider Details

I. General information

NPI: 1154814432
Provider Name (Legal Business Name): ANNA CLAIRE S DALRYMPLE OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNA CLAIRE J SPRADLING OD

II. Dates (important events)

Enumeration Date: 06/11/2018
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 HIGHWAY 12 W STE F
STARKVILLE MS
39759-3573
US

IV. Provider business mailing address

706 HIGHWAY 12 W STE F
STARKVILLE MS
39759-3573
US

V. Phone/Fax

Practice location:
  • Phone: 662-323-0571
  • Fax:
Mailing address:
  • Phone: 662-323-0571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number977
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: