Magnolia Eye Group | |
130 W Van Dorn Ave, Holly Springs, MS 38635-2902 | |
(662) 252-3323 | |
Not Available |
Full Name | Magnolia Eye Group |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 130 W Van Dorn Ave, Holly Springs, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1356430987 | NPI | - | NPPES |
05784776 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Provider Name | Eric D Randle |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1336247816 PECOS PAC ID: 1254331960 Enrollment ID: I20070103000236 |
Provider Name | Stephen Edwards |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1013015585 PECOS PAC ID: 5799785408 Enrollment ID: I20070111000052 |
Provider Name | Hunter Edwards |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1326613308 PECOS PAC ID: 0042616013 Enrollment ID: I20210831002354 |
Provider Name | Taylor Watkins Edwards |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1548995509 PECOS PAC ID: 2860875952 Enrollment ID: I20220823001988 |
Provider Name | Sarah Avera Thrower |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1780363580 PECOS PAC ID: 4688036296 Enrollment ID: I20230814004022 |
Mailing Address | Practice Location Address |
---|---|
Magnolia Eye Group 130 W Van Dorn Ave, Holly Springs, MS 38635-2902 Ph: (662) 252-3323 | Magnolia Eye Group 130 W Van Dorn Ave, Holly Springs, MS 38635-2902 Ph: (662) 252-3323 |
Dr. Katherine Cragon Randolph, OD Optometrist Medicare: May Accept Medicare Assignments Practice Location: 130 W Van Dorn Ave, Holly Springs, MS 38635 Phone: 662-252-3323 | |
Sarah Avera Thrower, OD Optometrist Medicare: Medicare Enrolled Practice Location: 640 J M Ash Dr, Holly Springs, MS 38635 Phone: 662-252-3323 |