Provider Demographics
NPI:1053743781
Name:ROGERS FAMILY EYE CARE, LLC
Entity type:Organization
Organization Name:ROGERS FAMILY EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF OPTOMETRY
Authorized Official - Prefix:DR
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:662-587-1926
Mailing Address - Street 1:1000 HIGHLAND COLONY PKWY STE 9007
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-2083
Mailing Address - Country:US
Mailing Address - Phone:601-957-6078
Mailing Address - Fax:601-957-6924
Practice Address - Street 1:1000 HIGHLAND COLONY PKWY STE 9007
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-2083
Practice Address - Country:US
Practice Address - Phone:601-957-6078
Practice Address - Fax:601-957-6924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
152W00000X
MS875261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty