EYECARE SURGERY CENTER LLC NPI 1821336371

NPI Information

NPI: 1821336371
Provider Name: EYECARE SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 25D2053255

Address:
1501 LAKELAND DR STE 101
JACKSON, MS
ZIP 39216
Phone: (601) 366-1085
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EYECARE SURGERY CENTER, LLC is an ambulatory surgical clinic center in Jackson, MS. EYECARE SURGERY CENTER, LLC NPI is 1821336371. The provider is registered as an organization entity type.

The provider's business location address is:

1501 LAKELAND DR STE 101
JACKSON, MS
ZIP 39216-839
Phone: (601) 366-1085
Fax: (601) 366-5186

The provider's authorized official is Kirk R Jeffreys .
The authorized official title is Owner and has the following contact phone number (601) 366-1085.

The CLIA number assigned to this NPI record is 25D2053255 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/17/2013 and was last updated on 1/17/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	14957	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	180000283	MEDICARE PIN	MISSISSIPPI
2	00120588	MEDICAID	MISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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