The Vision Clinic Of Vicksburg Llc
LBN: The Vision Clinic Of Vicksburg Llc
The Vision Clinic Of Vicksburg Llc is an health care organization with primary practice located at 1808 Mission 66 , Vicksburg MS 39180-3710. The organization recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Suppliers / Eyewear Supplier (Equipment, not the service). Eye and Vision Services Providers / Optometrist is the primary health care specialty.
The Vision Clinic Of Vicksburg Llc can be contacted via phone (601) 636-6364, or through Ashley, William Samuel 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:
Authorized official contact:
Name: Ashley, William Samuel Doctor of Optometry (OD)
Phone: (601) 636-6364
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 487 | Mississippi |
| Suppliers / Eyewear Supplier (Equipment, not the service) | 332H00000X | 487 | Mississippi |
Profile Details
| NPI number | 1871602862 |
|---|---|
| LBN Legal business name | The Vision Clinic Of Vicksburg Llc |
| DBA Doing business as | |
| Authorized official | Ashley, William Samuel Doctor of Optometry (OD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Jul 12th, 2023 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871602862 | NPPES |
| Mississippi | MEDICAID | 00087909 |
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