Provider Demographics
NPI:1629784269
Name:EYECARE PROFESSIONALS OF MISSISSIPPI, PLLC
Entity Type:Organization
Organization Name:EYECARE PROFESSIONALS OF MISSISSIPPI, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:
Authorized Official - Last Name:JEFFREYS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-366-1085
Mailing Address - Street 1:1501 LAKELAND DR STE 100
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4869
Mailing Address - Country:US
Mailing Address - Phone:601-366-1085
Mailing Address - Fax:
Practice Address - Street 1:240 BELLE MEADE PT
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-3310
Practice Address - Country:US
Practice Address - Phone:601-366-1085
Practice Address - Fax:769-867-9123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty