NPI 1306925029

Michael Edward Obrien, OD

Practitioner Optometrist Southaven, MS

Practice location

Address: 1890 Goodman Rd E Suite 100, Southaven, MS 38671-9552
Phone: (662) 772-5882
Fax: (662) 772-5808

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 593 (MS)

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Registry record

NPI: 1306925029
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Nov 2006
Record last updated: 27 Jul 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.