| NPI | 1447468368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEMESHA TOLIVER Office Manager 662-844-7211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 174400000X Specialist (Licence: MS 12479) |
| 152W00000X Optometrist (Licence: MS 698) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2024-09-25 |