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General NPI Number Information
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NPI Number | 1962412429
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Entity Type | Organization
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Legal Business Name | MISSISSIPPI VISION CORRECTION CENTER, PLLC
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 1053 RIVER OAKS DR
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City | FLOWOOD
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State | MS
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Zip | 39232-9595
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Country | US
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Telephone | 601-969-1430
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Fax | 601-709-2117
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Provider Business Mailing Address
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Address Line | 1053 RIVER OAKS DR
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City | FLOWOOD
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State | MS
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Zip | 39232-9595
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Country | US
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Telephone | 601-969-1430
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Fax | 601-709-2117
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. LESLIE B ADEN
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Credential | M.D.
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Telephone | 601-969-1430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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