SOUTHERN EYE PHYSICIANS CENTER, LLC (NPI# 1235316266) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235316266 |
| Entity Type | Organization |
| Organization Name | SOUTHERN EYE PHYSICIANS CENTER, LLC |
| Other Organization Name | SOUTHERN EYE CENTER |
| Practice Address |
1420 S 28th Ave Hattiesburg MS 39402-3107 |
| Practice Telephone | 6012643937 |
| Practice Fax Number | 6012645930 |
| Mailing Telephone | 6012643937 |
| Mailing Fax Number | 6012645930 |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-12-29 |
| Authorized Official Name | DR. LYNN B MCMAHAN (MANAGING MEMBER/PRESIDENT) |
| Authorized Official Telephone | 6012643937 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09014315 | 05 | |
| MS | MEDICARE PTAN | 512G700152 | 01 |
| Other Name | Type Code |
|---|---|
| Southern Eye Center | Doing Business As Name - Organization |
| Street Address |
1420 S 28TH AVE |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39402-3107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669475695 | Lynn Bryce Mcmahan | Ophthalmology | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2005-05-23 |
| 1124494109 | Amy Grubbs, Np-c, Pllc | Nurse Practitioner | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2015-08-13 |
| 1811144348 | Southern Eye Center P.a. II | Clinic/Center | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2008-08-27 |
| 1417112277 | Southern Eye Surgery Center LLC | Clinic/Center | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2008-07-22 |
| 1073791158 | Southern Eye Surgery Center LLC | Clinic/Center | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2008-01-31 |
| 1376725259 | Southern Eye Center P.a. II | Ophthalmology | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2007-12-03 |
| 1518097815 | Cameron S Griffith | Ophthalmology | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2007-03-06 |
| 1265435010 | Southern Eye Center P.a. II | Clinic/Center | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2005-05-24 |
| 1548263312 | Kiper Cecil Nelson | Ophthalmology | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2005-05-24 |
| 1932102951 | Jaime Jimenez Agosto | Ophthalmology | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2005-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518572965 | Resilient Therapy and Solutions, Pllc | Clinic/Center | 5266 Old Hwy 11 Ste 50, #308, Hattiesburg, MS 39402 | 2020-09-12 |
| 1932710225 | Jones County Medical Supplies, Inc | Durable Medical Equipment & Medical Supplies | 6424 Hwy 98 West, Suite 20, Hattiesburg, MS 39402 | 2020-08-11 |
| 1467086736 | Elizabeth A. Perry | Technician | 1220 Marrie St, Hattiesburg, MS 39402 | 2020-02-26 |
| 1225678063 | Connor Gregory Galloway | Physical Therapist | 3688 Veteran Memorial Drive, Hattiesburg, MS 39402 | 2020-01-09 |
| 1487291456 | Megan Marie Smith | Social Worker | 11 Woodstone Plaza, Hattiesburg, MS 39402 | 2019-12-09 |
| 1821656612 | Julie Covington Mcmahan | Dentist | 100 Madison Plaza, Hattiesburg, MS 39402 | 2019-06-05 |
| 1295392074 | Hattiesburg Clinic, Pa | Preventive Medicine | 6414 Highway 98, Suite 120, Hattiesburg, MS 39402 | 2019-05-28 |
| 1760945356 | Rachandeep Chahal | Student in an Organized Health Care Education/Training Program | 5001 Hardy Street Merit Health Wesley, Hattiesburg, MS 39402 | 2019-04-10 |
| 1386101137 | Courtney L Smith | Behavior Technician | 32 Millbanch Road, Suite 40, Hattiesburg, MS 39402 | 2019-02-28 |
| 1891269940 | Amanda Laine Mcarthur-macisaac | Registered Nurse | 5909 Highway 49 South, Suite 30, Hattiesburg, MS 39402 | 2019-01-11 |
| Find all providers in zip 39402 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184785065 | Hattiesburg Clinic Pa | Ophthalmology | 6414 Highway 98 West, Suite 80, Hattiesburg, MS 39402 | 2006-12-13 |
| 1568570117 | Charles David Richardson | Ophthalmology | 100 Hospital Dr W, Hattiesburg, MS 39402-1334 | 2006-08-25 |
| 1679558357 | Martin L Thomley | Ophthalmology | 109 Millsaps Dr Ste B, Hattiesburg, MS 39402-1587 | 2005-12-14 |
| 1891797825 | John Langan Pendergrass | Ophthalmology | 102 E Hospital Dr, Hattiesburg, MS 39402-1310 | 2005-08-10 |
| 1669475695 | Lynn Bryce Mcmahan | Ophthalmology | 1420 S 28th Ave, Hattiesburg, MS 39402-3107 | 2005-05-23 |
| 1588109821 | Retina Specialists of Mississippi, Pllc | Ophthalmology | 109 Millsaps Dr Ste B, Hattiesburg, MS 39402-1587 | 2016-12-22 |
| 1366853020 | Benjamin Robert Pace | Ophthalmology | 100 Hospital Dr W, Hattiesburg, MS 39402 | 2014-05-15 |
| 1306281852 | Adam Ellington Quinn | Ophthalmology | 100 Hospital Dr W, Hattiesburg, MS 39402 | 2013-05-09 |
| 1174781231 | Wright Benjamin Lauten | Ophthalmology | 109 Millsaps Dr, Suite B, Hattiesburg, MS 39402-1587 | 2008-05-27 |
| 1972786150 | Gabriella Szatmary | Ophthalmology | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2007-12-11 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39402 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.