MEDICARE: DR. ROBERT SEARCY SHIPP V O.D.

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
1	152W00000X	Optometrist	719	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225044001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT SEARCY SHIPP V O.D.

Provider Business Mailing Address
First Line	:	1831 S. MARTIN LUTHER KING BLVD
Second Line	:
City	:	GREENVILLE
State	:	MS
Zip	:	38701
Country	:	US
Telephone Number	:	662-378-3318
Fax Number	:

Provider Business Practice Location Address
First Line	:	1831 S. MARTIN LUTHER KING BLVD.
Second Line	:
City	:	GREENVILLE
State	:	MS
Zip	:	38701
Country	:	US
Telephone Number	:	662-378-3318
Fax Number	:	662-378-3317

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	11/02/2010

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