Charleston Vision Center Pa | |
288 W Main St, Charleston, MS 38921-2229 | |
(662) 647-8707 | |
(662) 647-8706 |
Full Name | Charleston Vision Center Pa |
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Type | Facility |
Speciality | Optometrist |
Location | 288 W Main St, Charleston, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1932440138 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 722 (Mississippi) | Secondary |
152W00000X | Optometrist | (Mississippi) | Primary |
Provider Name | Jonathan Wilson |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1881738532 PECOS PAC ID: 7315901592 Enrollment ID: I20080303000201 |
Provider Name | Michael E Obrien |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1306925029 PECOS PAC ID: 1153405030 Enrollment ID: I20080306000398 |
Provider Name | Ty H Smith |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1992282529 PECOS PAC ID: 7911241773 Enrollment ID: I20181205000242 |
Mailing Address | Practice Location Address |
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Charleston Vision Center Pa 1890 Goodman Rd E, Suite 100, Southaven, MS 38671-9504 Ph: () - | Charleston Vision Center Pa 288 W Main St, Charleston, MS 38921-2229 Ph: (662) 647-8707 |
Tallahatchie Eyecare, Pllc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 203 S Market St, Charleston, MS 38921 Phone: 662-647-3500 | |
Obrien Eye Care Optometrist Medicare: Not Enrolled in Medicare Practice Location: 426 E Main St, Charleston, MS 38921 Phone: 662-647-8707 Fax: 662-647-8706 | |
David V Obrien, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 426 E Main St, Charleston, MS 38921 Phone: 662-647-8707 Fax: 662-647-8706 |