Provider Demographics
NPI:1518037290
Name:EYE CENTER OF NATCHEZ, INC
Entity Type:Organization
Organization Name:EYE CENTER OF NATCHEZ, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-445-5884
Mailing Address - Street 1:10 VISION LN
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-4607
Mailing Address - Country:US
Mailing Address - Phone:601-445-5884
Mailing Address - Fax:601-446-7732
Practice Address - Street 1:10 VISION LN
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-4607
Practice Address - Country:US
Practice Address - Phone:601-445-5884
Practice Address - Fax:601-446-7732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2010-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS10821207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09014974Medicaid
MSCI9196OtherMEDICARE RAILROAD GROUP
LA1341746Medicaid
LA5CV48OtherMEDICARE GROUP
LA5CV48OtherMEDICARE GROUP
MS0591140001Medicare NSC
LA1341746Medicaid