Provider Demographics
NPI:1437311347
Name:ALCORN EYE CARE INC.
Entity Type:Organization
Organization Name:ALCORN EYE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:ANDY
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:662-287-1297
Mailing Address - Street 1:2301 S HARPER RD
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-6771
Mailing Address - Country:US
Mailing Address - Phone:662-287-1297
Mailing Address - Fax:662-286-1060
Practice Address - Street 1:2301 S HARPER RD
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-6771
Practice Address - Country:US
Practice Address - Phone:662-287-1297
Practice Address - Fax:662-286-1060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS613152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06373OtherSPECTERA
933315OtherBLOCK VISION OR VISION INSURANCE PLAN OF AMERICA
MS00880081Medicaid
153147OtherCOLE MANAGED VISON PROVIDER
988665OtherOPTI CHOICE
103323OtherALWAYS VISION
47672OtherDAVIS VISION