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General NPI Number Information
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NPI Number | 1447511571
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Entity Type | Organization
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Legal Business Name | LAGNIAPPE EYE CARE INC.
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Dates
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Enumeration Date | 06/05/2012
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Last Update Date | 04/13/2015
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Provider Practice Location Address
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Address Line | 6152 U S HIGHWAY 98 SUITE 30
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City | HATTIESBURG
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State | MS
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Zip | 39402-4200
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Country | US
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Telephone | 601-336-8062
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Fax |
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Provider Business Mailing Address
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Address Line | 6152 U S HIGHWAY 98 SUITE 30
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City | HATTIESBURG
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State | MS
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Zip | 39402-4200
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Country | US
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Telephone | 601-336-8062
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DEBORAH MARCEV
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Credential | OD
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Telephone | 601-329-1796
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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 | 689
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License Number State | MS
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