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NPI Code Detail

MEDICARE: MISSISSIPPI EYE ASSOCIATES

MEDICARE: MISSISSIPPI EYE ASSOCIATES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician12585MS

General Provider Information

NPI Number : 1033428990
Entity Type Code : Organization
Provider Name (Legal Business Name) : MISSISSIPPI EYE ASSOCIATES
Provider Business Mailing Address
First Line : 3631 BIENVILLE BLVD
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-5702
Country : US
Telephone Number : 228-875-2020
Fax Number :
Provider Business Practice Location Address
First Line : 3631 BIENVILLE BLVD
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-5702
Country : US
Telephone Number : 228-875-2020
Fax Number :
Authorized Official
Title or Position : OFFICE MANAGER
Name : TAWANNA MICHELLE MCMILLIAN
Credential :
Telephone Number : 228-875-2020
Provider Enumeration Date : 09/27/2010
Last Update Date : 09/27/2010

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Directions to “MISSISSIPPI EYE ASSOCIATES ” Practice Location

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