SOUTHERN EYE CENTER OF EXCELLENCE – NPI #1073791158
Clinic/Center

SOUTHERN EYE CENTER OF EXCELLENCE is an AHC clinic located in HATTIESBURG, MS. NPPES has assigned the NPI number 1073791158 to SOUTHERN EYE CENTER OF EXCELLENCE on January 31, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SOUTHERN EYE CENTER OF EXCELLENCE” is a dba name, the actual legal business name for this organization is SOUTHERN EYE SURGERY CENTER LLC. The primary taxonomy selected by this provider is 261QS0132X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ophthalmologic Surgery

The NPI profile was previously updated about 17 years ago on Jan 15, 2009. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SOUTHERN EYE CENTER OF EXCELLENCE below.

NPI Profile for
SOUTHERN EYE SURGERY CENTER LLC

NPI Number
1073791158
Enumeration Date

(more than 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SOUTHERN EYE SURGERY CENTER LLC
Doing Business As (dba): SOUTHERN EYE CENTER OF EXCELLENCE
Primary location
1420 S 28TH AVE
HATTIESBURG, MS 39402-3107
Phone: (601) 264-3937 Fax: (601) 264-5930
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
LYNN MCMAHAN
PRESIDENT
Phone: (601) 264-3937
Updated
Identifiers

Identifiers for SOUTHERN EYE CENTER OF EXCELLENCE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERMEDICARE PTAN FOR SOUTHERN EYE SURGERY CENTER LLCMS512G490003
MEDICAIDMS00770066
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QS0132X
- Clinic/Center / Ophthalmologic Surgery (Primary)		 MS 010

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.