MID-SOUTH RETINA ASSOCIATES, LLC – NPI #1639891088
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.

Health Care Provider Taxonomy Code for Ophthalmology

MID-SOUTH RETINA ASSOCIATES, LLC is an ophthalmologist located in OLIVE BRANCH, MS. NPPES has assigned the NPI number 1639891088 to MID-SOUTH RETINA ASSOCIATES, LLC on September 13, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207W00000X from the Health Care Provider Taxonomy code set, which is classified as Ophthalmology.

The NPI profile was previously updated about 4 years ago on Oct 19, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MID-SOUTH RETINA ASSOCIATES, LLC below.

NPI Profile for
MID-SOUTH RETINA ASSOCIATES, LLC

NPI Number
1639891088
Enumeration Date

(more than 3 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MID-SOUTH RETINA ASSOCIATES, LLC
Primary location
6760 GOODMAN RD STE 125
OLIVE BRANCH, MS 38654-7056
Phone: (901) 682-1100 Fax: (731) 265-2913
Mailing address
PO BOX 1000 DEPT 448
MEMPHIS, TN 38148-0001
Phone: (901) 682-1100 Fax:
Organization Subpart
Yes - MID-SOUTH RETINA ASSOCIATES, LLC is subpart of another organization.
Authorized Official
BRIAN BRADBERRY
PRACTICE ADMINISTRATOR
Phone: (731) 427-7799
Updated
Certification Date
Oct 19, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207W00000X
- Ophthalmology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.