Provider Demographics
NPI:1699857771
Name:WEBB, SHERYLAN ANNE (OD)
Entity Type:Individual
Prefix:DR
First Name:SHERYLAN
Middle Name:ANNE
Last Name:WEBB
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:1085 STARK RD STE C
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-3682
Mailing Address - Country:US
Mailing Address - Phone:662-320-6636
Mailing Address - Fax:662-320-3838
Practice Address - Street 1:1085 STARK RD STE C
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-3682
Practice Address - Country:US
Practice Address - Phone:662-320-6636
Practice Address - Fax:662-320-3838
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS767152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist