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General NPI Number Information
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NPI Number | 1780889923
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Entity Type | Organization
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Legal Business Name | HATTIESBURG EYE CLINIC, PA
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1431 NORTH 10TH ST SUITE 1
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City | LAUREL
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State | MS
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Zip | 39440
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Country | US
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Telephone | 601-649-6507
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Fax |
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Provider Business Mailing Address
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Address Line | 1431 NORTH 10TH STREET SUITE 1
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City | LAUREL
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State | MS
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Zip | 39440
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Country | US
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Telephone | 601-649-6507
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Fax |
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Authorized Official
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Title or Position | OPHTHALMOLOGIST
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Name | DR. TODD D. WILLIAMSON
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Credential | D.O.
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Telephone | 601-649-6507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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