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MID-SOUTH RETINA ASSOCIATES LLC NPI 1215963350


NPI Information

NPI: 1215963350
Provider Name: MID-SOUTH RETINA ASSOCIATES, LLC
Classification: Ophthalmology - 207W00000X
Entity Type: Organization
Address:
6005 PARK AVE
SUITE 624B
MEMPHIS, TN
ZIP 38119
Phone: (901) 682-1100
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MID-SOUTH RETINA ASSOCIATES, LLC is an ophthalmology in Memphis, TN. The provider is 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. MID-SOUTH RETINA ASSOCIATES, LLC NPI is 1215963350. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6005 PARK AVE
SUITE 624B
MEMPHIS, TN
ZIP 38119-202
Phone: (901) 682-1100
Fax: (901) 682-6915

The provider's authorized official is Richard Ervin Sievers .
The authorized official title is Partner and has the following contact phone number (901) 682-1100.

The enumeration date for this NPI number is 6/23/2006 and was last updated on 1/28/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207W00000XOphthalmologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13387047MEDICAIDTENNESSEE
23387047MEDICARE PINTENNESSEE
3CN2242MEDICARE PINTENNESSEE
4H44349MEDICARE UPINTENNESSEE
5E35201MEDICARE UPINTENNESSEE
6G02244MEDICARE UPINTENNESSEE
70053763OTHERTENNESSEEBLUE CROSS OF TENNESSEE
84067262OTHERTENNESSEEBLUE CROSS OF TENNESSEE
93066300OTHERTENNESSEEBLUE CROSS OF TENNESSEE
103104352OTHERTENNESSEEBLUE CROSS OF TENNESSEE
11A97534MEDICARE UPINTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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