MENDENHALL OPTOMETRIC EYE CLINIC, P.A. (NPI# 1184742843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184742843 |
| Entity Type | Organization |
| Organization Name | MENDENHALL OPTOMETRIC EYE CLINIC, P.A. |
| Other Organization Name | MENDENHALL EYE CLINIC |
| Practice Address |
1021 East St Mendenhall MS 39114-3107 |
| Mailing Address |
P. O. Box 577 Mendenhall MS 39114-3107 |
| Practice Telephone | 6018471232 |
| Practice Fax Number | 6018471376 |
| Mailing Telephone | 6018471232 |
| Mailing Fax Number | 6018471376 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | PAUL WILLARD CLARK (PRESIDENT) |
| Authorized Official Telephone | 6018471232 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 423 | MS | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | GROUP SUPPLIER CODE | C03245 | 01 |
| MS | 00087015 | 05 |
| Other Name | Type Code |
|---|---|
| Mendenhall Eye Clinic | Doing Business As Name - Organization |
| Street Address |
1021 EAST ST |
| City | MENDENHALL |
| State | MS |
| Zip Code | 39114-3107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538593553 | Rita Seater Parker | Occupational Therapy Assistant | 925 West Mangum Blvd., Mendenhall, MS 39114 | 2013-08-27 |
| 1740573633 | Sheree Walters | Physical Therapy Assistant | 925 West Mangum Blvd, Mendenhall, MS 39114 | 2011-05-25 |
| 1346300423 | Amnuey M Chiemprabha Md Pa | Surgery | 820 Mangum Ave, Mendenhall, MS 39114 | 2006-12-11 |
| 1982620274 | Family Health Care Clinic, Inc. | Clinic/Center | 401 Main St N, Mendenhall, MS 39114 | 2006-07-13 |
| 1811318942 | Anna Lauren Wallace | Dietitian, Registered | 102 N. Main St., Mendenhall, MS 39114 | 2013-12-16 |
| 1639249568 | Glenn A Brien Sr. | Dentist | 122 Main St, Mendenhall, MS 39114 | 2006-11-08 |
| 1710382619 | Patriot Home Care | Respite Care | 324 Mangum Ave, Mendenhall, MS 39114-3015 | 2014-11-04 |
| 1346606191 | Jaytoria Wilkins | Chore Provider | 324 Mangum Ave, Mendenhall, MS 39114-3015 | 2016-01-09 |
| 1588106553 | 121 Medical Place, Inc | Clinic/Center | 820 Mangum Ave, Mendenhall, MS 39114-3025 | 2016-11-08 |
| 1497737571 | Bedford Care Center of Mendenhall, LLC | Skilled Nursing Facility | 925 Mangum Ave, Mendenhall, MS 39114-3026 | 2005-11-15 |
| Find all providers in zip 39114 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760739064 | Sgec, Inc | Optometrist | 1827 C Simpson Highway 149, Mendenhall, MS 39114-3439 | 2012-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386252609 | Primary Eyecare South LLC | Optometrist | 1217 S Frontage Rd Ste E, Meridian, MS 39301-6124 | 2020-07-22 |
| 1497371306 | Premier Eye Care, Pllc | Optometrist | 940 W Commerce St, Aberdeen, MS 39730-2337 | 2020-06-17 |
| 1902430937 | Dr Elizabeth M Darby Optometrist Pllc | Optometrist | 504 Easel St, Taylor, MS 38673 | 2020-02-28 |
| 1699320929 | Channing F Bucklew | Optometrist | 3090 N Church Ave, Louisville, MS 39339-6349 | 2019-08-05 |
| 1083266498 | Royce Vandiver Miles Jr. | Optometrist | 521 Deerfield Dr, Forest, MS 39074-6006 | 2019-07-15 |
| 1952965022 | Byhalia Vision Center LLC | Optometrist | 8250 Hwy 178 West, Byhalia, MS 38611-6776 | 2019-04-24 |
| 1770044497 | Tri County Eye Clinic, Pllc | Optometrist | 3430 Bienville Boulevard, Ocean Springs, MS 39564-5732 | 2019-03-26 |
| 1508351628 | Hilarie Nixon Holt | Optometrist | 301 Northlake Ave Ste 101, Ridgeland, MS 39157-1720 | 2018-06-30 |
| 1770097883 | Keeping Focus LLC. | Optometrist | 4223 I-20 Frontage Rd Apt J18, Vicksburg, MS 39183-3533 | 2017-11-28 |
| 1386168730 | Nettie Hines | Optometrist | 1006 Treetops Blvd Ste 105, Flowood, MS 39232-7645 | 2017-07-27 |
| Find all providers with the same taxonomy | ||||
| City | MENDENHALL |
| Zip Code | 39114 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.