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General NPI Number Information
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NPI Number | 1942285564
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Entity Type | Organization
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Legal Business Name | EYE CLINIC OF MERIDIAN PLLC
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 1301 20TH AVE
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City | MERIDIAN
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State | MS
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Zip | 39301-4121
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Country | US
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Telephone | 601-485-2368
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Fax | 601-693-2174
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Provider Business Mailing Address
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Address Line | PO BOX 1551
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City | MERIDIAN
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State | MS
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Zip | 39302-1551
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Country | US
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Telephone | 601-485-2368
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Fax | 601-693-2174
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Authorized Official
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Title or Position | SENIOR PARTNER
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Name | DR. DON E MARASCALCO
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Credential | MD
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Telephone | 601-485-2368
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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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Taxonomy #2
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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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