NPIMap

Organization Active NPI

Indianola Eye Clinic PA

Doing business as Delta Eye Center

  • Optometrist
  • Indianola, MS
National Provider Identifier
1578730800
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
460 Issued in MS
Legal business name
INDIANOLA EYE CLINIC PA
Doing business as
Delta Eye Center
Practice address
224 Virginia St
Indianola, MS 38751-2221
Phone
(662) 887-3671
Fax
(662) 887-3675
NPI assigned
May 15, 2008
Last updated
May 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Wilburn Lord, O.D.NPI 1548301864
Title
President
Phone
(662) 332-0163

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 460 MS Primary

Addresses

Primary practice location

224 Virginia St
Indianola, MS 38751-2221

Mailing address

239 S. Washington Ave.
Greenville, MS 38704
Phone (662) 332-0163

Other names 1

  • Delta Eye Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1578730800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 S. WASHINGTON AVE.",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "38704",
            "telephone_number": "662-332-0163",
            "fax_number": "662-378-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 VIRGINIA ST",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387512221",
            "telephone_number": "662-887-3671",
            "fax_number": "662-887-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANOLA EYE CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "LORD",
        "authorized_official_first_name": "WILBURN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-332-0163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delta Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indianola, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.