Provider Demographics
NPI:1639611619
Name:EYES2SEE, P.A.
Entity Type:Organization
Organization Name:EYES2SEE, P.A.
Other - Org Name:DR. JULIE C. BROCK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:BROCK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:662-316-3761
Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:MS
Mailing Address - Zip Code:38652-0510
Mailing Address - Country:US
Mailing Address - Phone:662-534-9288
Mailing Address - Fax:662-534-8341
Practice Address - Street 1:109 STATE HIGHWAY 15 S
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:MS
Practice Address - Zip Code:38652-5206
Practice Address - Country:US
Practice Address - Phone:662-534-9288
Practice Address - Fax:662-534-8341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS661152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00737224Medicaid
MS410000361Medicare PIN
MSU88936Medicare UPIN