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General NPI Number Information
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NPI Number | 1952651523
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Entity Type | Organization
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Legal Business Name | MILLIKEN EYE CARE, LLC
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Dates
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Enumeration Date | 09/11/2012
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 202 ADVOCATE ROW
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City | VIDALIA
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State | LA
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Zip | 71373-3000
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Country | US
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Telephone | 601-443-9876
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Fax | 601-442-4000
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Provider Business Mailing Address
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Address Line | 202 ADVOCATE ROW
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City | VIDALIA
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State | LA
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Zip | 71373-3000
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Country | US
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Telephone | 601-443-9876
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Fax | 601-442-4000
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. NANCY ANDERS
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Credential |
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Telephone | 601-443-9876
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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 | 792
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License Number State | MS
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