| NPI | 1235009762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE T LEWIS Owner 601-985-9120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery |
| Enumeration Date | 2025-11-10 |
| Last Update Date | 2025-11-10 |