Hattiesburg Eye Clinic PA

Organization Active NPI Optometrist · Petal, MS

NPI 1962679043 · NPPES record last updated May 8, 2008

Key facts

NPI
1962679043
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
Legal business name
HATTIESBURG EYE CLINIC PA
Practice address
1223 Hwy 42
Ste 140
Petal, MS 39465
Phone
(601) 445-0226
Fax
(601) 450-2264
NPI assigned
May 8, 2008
Organization subpart
No

Authorized official

Name
Stoney Williamson, MD
Title
President
Phone
(601) 268-5910

Corporate family (same tax ID) 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Hattiesburg Eye Clinic PA (5 organizations share this tax ID)

Locations

1223 Highway 42
Ste 140
Petal, MS 39465
Phone (601) 445-0226

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X Yes

Addresses

Primary practice location

1223 Hwy 42
Ste 140
Petal, MS 39465

Mailing address

100 Hospital Dr W
Hattiesburg, MS 39402-1334
Phone (601) 268-5910

Other providers in Petal, MS

All providers in Petal, MS · Optometrist in Mississippi

Sources for this page

Verify at the official NPI Registry.