| Poplarville Eye Clinic, Llc | |
|
1716 S Main St, Poplarville, MS 39470-4287 | |
| (601) 795-0137 | |
| (601) 795-0148 |
| Full Name | Poplarville Eye Clinic, Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 1716 S Main St, Poplarville, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962800011 | NPI | - | NPPES |
| 00880221 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 685 (Mississippi) | Primary |
| Provider Name | Bethany G Harrington |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1750350070 PECOS PAC ID: 3779608047 Enrollment ID: I20100910000507 |
| Provider Name | Marc A Hautot |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1346215274 PECOS PAC ID: 7911031026 Enrollment ID: I20111031000176 |
| Provider Name | Bonnie Elizabeth Keaton |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1306435722 PECOS PAC ID: 5991110173 Enrollment ID: I20210222000683 |
| Mailing Address | Practice Location Address |
|---|---|
| Poplarville Eye Clinic, Llc Po Box 521, Poplarville, MS 39470-0521 Ph: (601) 795-0137 | Poplarville Eye Clinic, Llc 1716 S Main St, Poplarville, MS 39470-4287 Ph: (601) 795-0137 |
Picayune Eye Clinic Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1249 S Main St, Poplarville, MS 39470 Phone: 601-795-0137 Fax: 601-798-4770 | |
Bethany G Harrington, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1716 S Main St, Poplarville, MS 39470 Phone: 601-795-0137 Fax: 601-795-0148 |