Provider Demographics
NPI:1285685230
Name:EYE EXAMINERS, INC.
Entity Type:Organization
Organization Name:EYE EXAMINERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:RANDOLPH
Authorized Official - Last Name:MARCEV
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OD
Authorized Official - Phone:601-264-2006
Mailing Address - Street 1:PO BOX 18516
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39404-8460
Mailing Address - Country:US
Mailing Address - Phone:601-264-2006
Mailing Address - Fax:601-264-9030
Practice Address - Street 1:6117 U S HIGHWAY 98 STE 20
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-7014
Practice Address - Country:US
Practice Address - Phone:601-264-2006
Practice Address - Fax:601-264-9030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03951894Medicaid