Provider Demographics
NPI:1467681130
Name:NEWMAN EYE CLINIC, PA
Entity type:Organization
Organization Name:NEWMAN EYE CLINIC, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:228-432-8141
Mailing Address - Street 1:724 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39530-4313
Mailing Address - Country:US
Mailing Address - Phone:228-432-8141
Mailing Address - Fax:228-432-8155
Practice Address - Street 1:724 JACKSON ST
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-4313
Practice Address - Country:US
Practice Address - Phone:228-432-8141
Practice Address - Fax:228-432-8155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS524152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty