Provider Demographics
NPI:1982718532
Name:EYE CARE OPTICAL
Entity type:Organization
Organization Name:EYE CARE OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:M
Authorized Official - Last Name:THURBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:228-875-3937
Mailing Address - Street 1:3420 BIENVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-5732
Mailing Address - Country:US
Mailing Address - Phone:228-875-3937
Mailing Address - Fax:228-875-3930
Practice Address - Street 1:3420 BIENVILLE BLVD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-5732
Practice Address - Country:US
Practice Address - Phone:228-875-3937
Practice Address - Fax:228-875-3930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS=========OtherTAX ID#