Provider Demographics
NPI:1003990193
Name:TOTAL EYE CARE PC
Entity Type:Organization
Organization Name:TOTAL EYE CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEATY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:662-862-6727
Mailing Address - Street 1:PO BOX 356
Mailing Address - Street 2:1310 E. WALKER ST.
Mailing Address - City:FULTON
Mailing Address - State:MS
Mailing Address - Zip Code:38843-0356
Mailing Address - Country:US
Mailing Address - Phone:662-862-6727
Mailing Address - Fax:662-862-7969
Practice Address - Street 1:1310 E. WALKER ST.
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MS
Practice Address - Zip Code:38843
Practice Address - Country:US
Practice Address - Phone:662-862-6727
Practice Address - Fax:662-862-7969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS669152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00880181Medicaid
MSU65756Medicare UPIN
MS00880181Medicaid
MSC02451Medicare PIN