Total Eye Care of Fulton P.a.
Organization Active NPI Clinic/Center · Fulton, MS
NPI 1043585953 · NPPES record last updated Mar 12, 2012
Key facts
- NPI
- 1043585953
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- License
- 808 (MS)
- Legal business name
- TOTAL EYE CARE OF FULTON P.A.
- Practice address
- 1310 E Walker St
Fulton, MS 38843 - Phone
- (662) 862-6727
- NPI assigned
- Mar 12, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Josh Hatfield, O.D.
- Title
- Owner/Optometrist
- Phone
- (662) 862-6727
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 1
Practitioners 5
-
Joshua Michael Hatfield, O.D.
-
Andrew Harrell McDonald, O.D.
-
Michael Sayonh, OD
-
Samantha T. Beaty, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130416000075 | MS | Part B Supplier - Clinic/Group Practice | 9537305610 |
Receives reassigned benefits from 4 practitioners 1 other NPI on this enrollment Practice locations: Amory, MS; Fulton, MS |
National Provider Directory
- Tax ID family
- Total Eye Care of Amory
Locations
1310 E Walker St
Fulton, MS 38843
Phone (601) 862-6727
1310 E Walker St
#A
Fulton, MS 38843
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | 808 | MS | Yes |
Addresses
Primary practice location
1310 E Walker St
Fulton, MS 38843
Mailing address
PO Box 356
Fulton, MS 38843-0356
Other providers in Fulton, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.