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NPI Code Detail

MEDICARE: MISSISSIPPI EYE SURGERY CENTER UC

MEDICARE: MISSISSIPPI EYE SURGERY CENTER UC
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
1261QA0900XAmputee Clinic/CenterMS

Other Identifiers

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

General Provider Information

NPI Number : 1609809326
Entity Type Code : Organization
Provider Name (Legal Business Name) : MISSISSIPPI EYE SURGERY CENTER UC
Provider Business Mailing Address
First Line : 3432 BIENVILLE BLVD
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564
Country : US
Telephone Number : 228-244-0067
Fax Number : 228-244-0071
Provider Business Practice Location Address
First Line : 3432 BIENVILLE BLVD
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564
Country : US
Telephone Number : 228-244-0067
Fax Number : 228-244-0071
Authorized Official
Title or Position : DIRECTOR
Name : MS. SANDY ROBERTSON
Credential : RN
Telephone Number : 228-244-0067
Provider Enumeration Date : 07/08/2006
Last Update Date : 08/05/2008

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Directions to “MISSISSIPPI EYE SURGERY CENTER UC ” Practice Location

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