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General NPI Number Information
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NPI Number | 1992389720
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Entity Type | Organization
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Legal Business Name | EYECARE PROFESSIONALS PA
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Dates
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Enumeration Date | 05/07/2021
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Last Update Date | 09/10/2021
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Provider Practice Location Address
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Address Line | 240 BELLE MEADE PT
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City | FLOWOOD
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State | MS
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Zip | 39232
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Country | US
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Telephone | 601-366-1085
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Fax | 601-366-5186
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Provider Business Mailing Address
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Address Line | 1501 LAKELAND DR. STE 100
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City | JACKSON
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State | MS
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Zip | 39216
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Country | US
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Telephone | 601-366-1085
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Fax | 601-366-5186
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIRK R JEFFREYS III
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Credential | MD
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Telephone | 601-366-1085
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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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