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General NPI Number Information
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NPI Number | 1386774263
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Entity Type | Organization
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Legal Business Name | BENEFIELD EYE CARE, PC
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11240 HIGHWAY 49 STE 300
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City | GULFPORT
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State | MS
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Zip | 39503-4151
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Country | US
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Telephone | 228-328-0972
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Fax |
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Provider Business Mailing Address
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Address Line | 11240 HIGHWAY 49 STE 300
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City | GULFPORT
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State | MS
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Zip | 39503-4151
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Country | US
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Telephone | 228-328-0972
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONALD W BENEFIELD
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Credential | MD
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Telephone | 228-328-0972
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 012410
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License Number State | MS
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