| Ted Harden Od Pllc | |
|
5901 U S Highway 49 Hattiesburg MS 39402-2858 | |
| (601) 268-6698 | |
| Not Available |
| Full Name | Ted Harden Od Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5901 U S Highway 49, Hattiesburg, Mississippi |
| Authorized Official Name and Position | Ted Gene Harden (OPTOMETRIST) |
| Authorized Official Contact | 6012686698 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ted Harden Od Pllc 110 Longwood Terrace Hattiesburg MS 39402 Ph: () - | Ted Harden Od Pllc 5901 U S Highway 49 Hattiesburg MS 39402-2858 Ph: (601) 268-6698 |
| NPI Number | 1780837682 |
|---|---|
| Provider Enumeration Date | 10/23/2008 |
| Last Update Date | 10/23/2008 |
| Medicare PECOS PAC ID | 2062570468 |
|---|---|
| Medicare Enrollment ID | O20081028000663 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780837682 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 786 (Mississippi) | Primary |
| Provider Name | Joe R Mitchell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1508949355 PECOS PAC ID: 1850495243 Enrollment ID: I20070323000362 |
| Provider Name | Ted G Harden |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396939542 PECOS PAC ID: 3375612625 Enrollment ID: I20080513000524 |
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