Provider Demographics
NPI:1780789172
Name:EYEDOK LLC
Entity type:Organization
Organization Name:EYEDOK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:OKELLEY HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:901-438-6088
Mailing Address - Street 1:6137 AUTUMN PT
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-6643
Mailing Address - Country:US
Mailing Address - Phone:901-438-6088
Mailing Address - Fax:
Practice Address - Street 1:6137 AUTUMN PT
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-6643
Practice Address - Country:US
Practice Address - Phone:901-438-6088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS751152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty