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General NPI Number Information
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NPI Number | 1033917638
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Entity Type | Organization
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Legal Business Name | HOLLY SPRINGS EYECARE PLLC
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 124 W COMMERCE ST
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City | HERNANDO
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State | MS
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Zip | 38632-2240
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Country | US
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Telephone | 662-647-1818
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Fax | 662-562-0600
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Provider Business Mailing Address
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Address Line | 302 RAILROAD ST
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City | WATER VALLEY
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State | MS
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Zip | 38965-3032
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Country | US
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Telephone | 662-473-6181
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHEN PATRICK EDWARDS
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Credential | OD
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Telephone | 662-473-2181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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