Hazlehurst Eye Clinic, P.C.
Organization Active NPI Optometrist · Hazlehurst, MS
NPI 1407010937 · NPPES record last updated Aug 26, 2008
Key facts
- NPI
- 1407010937
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 787 (MS)
- Legal business name
- HAZLEHURST EYE CLINIC, P.C.
- Practice address
- 118 Caldwell Dr
Hazlehurst, MS 39083-3023 - Phone
- (601) 894-2951
- Fax
- (601) 894-2952
- NPI assigned
- Jul 14, 2008
- Organization subpart
- No
Authorized official
- Name
- Chad P Smith, O.D.
- Title
- President
- Phone
- (601) 894-2951
National Provider Directory
Locations
118 Caldwell Dr
Hazlehurst, MS 39083
Phone (601) 894-2951
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 787 | MS | Yes |
Addresses
Primary practice location
118 Caldwell Dr
Hazlehurst, MS 39083-3023
Mailing address
118 Caldwell Dr
Hazlehurst, MS 39083-3023
Phone (601) 894-2951
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01081512 | Medicaid | MS |
Other providers in Hazlehurst, MS
- Alvin Dale Griffin
- Randy Hankins
- Hardy Wilson Memorial Hospital
- Hardy Wilson Memorial Hospital
- Hazlehurst Elementary School
- Hazlehurst Vision Clinic
- Heavenly Hands Services, LLC
- Kentauria Henley
- Lynice Higgins
- Marvin E Hightower
All providers in Hazlehurst, MS · Optometrist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.