Provider Demographics
NPI:1588746390
Name:DSL INC
Entity type:Organization
Organization Name:DSL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEON
Authorized Official - Middle Name:
Authorized Official - Last Name:CEFALU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-853-1871
Mailing Address - Street 1:111 COLONY CROSSING
Mailing Address - Street 2:SUITE 220
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7778
Mailing Address - Country:US
Mailing Address - Phone:601-853-1871
Mailing Address - Fax:601-853-9154
Practice Address - Street 1:111 COLONY CROSSING
Practice Address - Street 2:SUITE 220
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-7778
Practice Address - Country:US
Practice Address - Phone:601-853-1871
Practice Address - Fax:601-853-9154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS5799950001Medicare NSC