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General NPI Number Information
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NPI Number | 1336895507
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Entity Type | Organization
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Legal Business Name | EYE CENTER OF NEW ALBANY
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Dates
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Enumeration Date | 02/26/2022
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 402 DOCTORS DR
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City | NEW ALBANY
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State | MS
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Zip | 38652-3109
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Country | US
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Telephone | 662-539-7771
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Fax | 662-539-7256
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Provider Business Mailing Address
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Address Line | 402 DOCTORS DR
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City | NEW ALBANY
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State | MS
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Zip | 38652-3109
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. MICHAEL WARE
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Credential | OD
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Telephone | 662-539-7771
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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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