SOUTHERN EYE CENTER P.A. II (NPI# 1265435010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265435010 |
| Entity Type | Organization |
| Organization Name | SOUTHERN EYE CENTER P.A. II |
| Other Organization Name | SOUTHERN EYE CENTER OF EXCELLENCE |
| Practice Address |
1420 S 28th Ave Hattiesburg MS 39402-3107 |
| Practice Telephone | 6012643937 |
| Practice Fax Number | 6012645930 |
| Mailing Telephone | 6012643937 |
| Mailing Fax Number | 6012645930 |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2008-08-15 |
| Authorized Official Name | MR. JOHN WEEMS (ADMINISTRATOR) |
| Authorized Official Telephone | 6012643937 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
010 | MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00770066 | 05 | |
| MS | 09014315 | 05 |
| Other Name | Type Code |
|---|---|
| Southern Eye Center of Excellence | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811144348 | Southern Eye Center P.a. II | Clinic/Center | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2008-08-27 |
| 1376725259 | Southern Eye Center P.a. II | Ophthalmology | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2007-12-03 |
| Street Address |
1420 S 28TH AVE |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39402-3107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669475695 | Lynn Bryce Mcmahan | Ophthalmology | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2005-05-23 |
| 1124494109 | Amy Grubbs, Np-c, Pllc | Nurse Practitioner | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2015-08-13 |
| 1811144348 | Southern Eye Center P.a. II | Clinic/Center | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2008-08-27 |
| 1417112277 | Southern Eye Surgery Center LLC | Clinic/Center | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2008-07-22 |
| 1073791158 | Southern Eye Surgery Center LLC | Clinic/Center | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2008-01-31 |
| 1235316266 | Southern Eye Physicians Center, LLC | Ophthalmology | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2008-01-22 |
| 1376725259 | Southern Eye Center P.a. II | Ophthalmology | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2007-12-03 |
| 1518097815 | Cameron S Griffith | Ophthalmology | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2007-03-06 |
| 1548263312 | Kiper Cecil Nelson | Ophthalmology | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2005-05-24 |
| 1932102951 | Jaime Jimenez Agosto | Ophthalmology | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2005-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518572965 | Resilient Therapy and Solutions, Pllc | Clinic/Center | 5266 Old Hwy 11 Ste 50, #308, Hattiesburg, MS 39402 | 2020-09-12 |
| 1932710225 | Jones County Medical Supplies, Inc | Durable Medical Equipment & Medical Supplies | 6424 Hwy 98 West, Suite 20, Hattiesburg, MS 39402 | 2020-08-11 |
| 1467086736 | Elizabeth A. Perry | Technician | 1220 Marrie St, Hattiesburg, MS 39402 | 2020-02-26 |
| 1225678063 | Connor Gregory Galloway | Physical Therapist | 3688 Veteran Memorial Drive, Hattiesburg, MS 39402 | 2020-01-09 |
| 1487291456 | Megan Marie Smith | Social Worker | 11 Woodstone Plaza, Hattiesburg, MS 39402 | 2019-12-09 |
| 1821656612 | Julie Covington Mcmahan | Dentist | 100 Madison Plaza, Hattiesburg, MS 39402 | 2019-06-05 |
| 1295392074 | Hattiesburg Clinic, Pa | Preventive Medicine | 6414 Highway 98, Suite 120, Hattiesburg, MS 39402 | 2019-05-28 |
| 1760945356 | Rachandeep Chahal | Student in an Organized Health Care Education/Training Program | 5001 Hardy Street Merit Health Wesley, Hattiesburg, MS 39402 | 2019-04-10 |
| 1386101137 | Courtney L Smith | Behavior Technician | 32 Millbanch Road, Suite 40, Hattiesburg, MS 39402 | 2019-02-28 |
| 1891269940 | Amanda Laine Mcarthur-macisaac | Registered Nurse | 5909 Highway 49 South, Suite 30, Hattiesburg, MS 39402 | 2019-01-11 |
| Find all providers in zip 39402 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| 1598911877 | George E. Wilkerson, M.d., P.a. | Clinic/Center | 348 Crossgates Blvd Ste 2300, Brandon, MS 39042-2634 | 2008-08-18 |
| 1174798334 | Don S Davis Md Pa | Clinic/Center | 5002 Hwy 39 N Bldg A, Meridian, MS 39301-1078 | 2008-04-28 |
| 1346424819 | North Mississippi Vascular Center, Pa | Clinic/Center | 1040a S Madison St, Tupelo, MS 38801-6300 | 2007-12-19 |
| Find all providers with the same taxonomy | ||||
| City | HATTIESBURG |
| Zip Code | 39402 |
Please comment or provide details below to improve the information on SOUTHERN EYE CENTER P.A. II.
| 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.