Ashley, Miles David

Ashley, Miles David is an individual health care provider with primary practice located at 1808 Mission 66 , Vicksburg MS 39180-3710. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Ashley, Miles David can be contacted via phone (601) 636-6364.

Contact Information

Primary practice address
1808 Mission 66 Vicksburg MS 39180-3710
Phone: (601) 636-6364
Fax: (601) 636-1162
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 878 Mississippi

Profile Details

NPI number 1518309277
LBN Legal business name Ashley, Miles David
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 23rd, 2013
Last updated Apr 3rd, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518309277 NPPES
Mississippi Other 878 MS STATE LICENSE
Mississippi MEDICAID 09001077 MS STATE LICENSE

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