Obrien, Michael Edward
Obrien, Michael Edward is an sole proprietor health care provider with primary practice located at 1890 Goodman Rd E Suite 100, Southaven MS 38671-9552. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Obrien, Michael Edward can be contacted via phone (662) 772-5882.Contact Information
Primary practice address
1890 Goodman Rd E Suite 100
Southaven MS 38671-9552
Phone: (662) 772-5882
Fax: (662) 772-5808
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 593 | Mississippi |
Profile Details
| NPI number | 1306925029 |
|---|---|
| LBN Legal business name | Obrien, Michael Edward |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 3rd, 2006 |
| Last updated | Jul 27th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306925029 | NPPES |
| Mississippi | MEDICAID | 09015435 |
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