Provider Demographics
NPI:1447443890
Name:CURTIS OPTOMETRY CLINIC AND DISPENSARY, P. A.
Entity type:Organization
Organization Name:CURTIS OPTOMETRY CLINIC AND DISPENSARY, P. A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:S
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:ABOC
Authorized Official - Phone:662-327-6341
Mailing Address - Street 1:PO BOX 9099
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-0038
Mailing Address - Country:US
Mailing Address - Phone:662-327-6341
Mailing Address - Fax:
Practice Address - Street 1:425 HOSPITAL DR
Practice Address - Street 2:SUITE 7
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-1901
Practice Address - Country:US
Practice Address - Phone:662-327-6341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0622440002Medicare NSC