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General NPI Number Information
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NPI Number | 1205513660
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Entity Type | Organization
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Legal Business Name | WEDO EYES LLC
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Dates
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Enumeration Date | 06/28/2023
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 3833 N GLOSTER ST
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City | TUPELO
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State | MS
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Zip | 38804-0914
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Country | US
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Telephone | 662-269-0856
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Fax | 662-269-0856
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Provider Business Mailing Address
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Address Line | 411 ERIC CV
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City | OXFORD
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State | MS
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Zip | 38655-5393
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Country | US
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Telephone | 662-269-0856
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Fax | 662-269-0856
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Authorized Official
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Title or Position | OWNER
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Name | JOSHUA HUNTER WILSON
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Credential | OD
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Telephone | 662-832-1609
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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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