MID-SOUTH RETINA ASSOCIATES, LLC (NPI# 1316973076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316973076 |
| Entity Type | Organization |
| Organization Name | MID-SOUTH RETINA ASSOCIATES, LLC |
| Practice Address |
529 N 10th St Blytheville AR 72315-1974 |
| Mailing Address |
Po Box 1000 Dept 448 Memphis TN 38148-0448 |
| Practice Telephone | 8707621942 |
| Practice Fax Number | 9016821100 |
| Mailing Telephone | 8707621942 |
| Mailing Fax Number | 9016826915 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2008-01-24 |
| Authorized Official Name | DR. RICHARD SIEVERS (PARTNER) |
| Authorized Official Telephone | 9016821100 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | MID-SOUTH RETINA ASSOCIATES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BLUE CROSS OF ARKANSAS | 5C535 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861428534 | Mid-south Retina Associates, LLC | Ophthalmology | 820 E Matthews Ave, Suite E, Jonesboro, AR 72401-3048 | 2006-06-24 |
| 1598700254 | Mid-south Retina Associates, LLC | Ophthalmology | 3302 W Linden St, Corinth, MS 38834-9188 | 2006-06-18 |
| 1235329145 | Mid-south Retina Associates, LLC | Ophthalmology | 1804 E Shiloh Rd, Corinth, MS 38834-3637 | 2007-07-26 |
| 1447286802 | Mid-south Retina Associates, LLC | Ophthalmology | 609 Skyline Dr, Jackson, TN 38301-3911 | 2006-06-25 |
| 1689600215 | Mid-south Retina Associates, LLC | Ophthalmology | 401 E Tickle St, Dyersburg, TN 38024-3163 | 2006-06-24 |
| 1215963350 | Mid-south Retina Associates, LLC | Ophthalmology | 6005 Park Ave, Suite 624b, Memphis, TN 38119-5202 | 2006-06-23 |
| 1255376919 | Mid-south Retina Associates, LLC | Ophthalmology | 300 S 8th St, Suite 284w, Murray, KY 42071-2400 | 2006-06-18 |
| Street Address |
529 N 10TH ST |
| City | BLYTHEVILLE |
| State | AR |
| Zip Code | 72315-1974 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760462584 | Constance H Smith | Specialist | 529 N 10th St, Blytheville, AR 72315-1974 | 2006-01-18 |
| 1043433204 | Constance H Smith Md Pa | Specialist | 529 N 10th St, Blytheville, AR 72315-1974 | 2007-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770055923 | Gosnell Drugs Inc. | Pharmacy | 134 Bevill Ave, Gosnell, AR 72315 | 2018-12-28 |
| 1770938441 | Kay Chan Powell | Optometrist | 527 N6th St, Ste A, Blythevile, AR 72315 | 2016-04-29 |
| 1124417142 | Victoria Jacoby | Nurse Practitioner | 1521 N. 10th Street, Suite A, Blytheville, AR 72315 | 2015-01-14 |
| 1154736635 | Hanna Kirk | Case Manager/Care Coordinator | 829 East Main St, Blytheville, AR 72315 | 2014-06-24 |
| 1700207909 | Hannah Browning | Speech-Language Pathologist | 4555 North State Highway 137, Blytheville, AR 72315 | 2013-12-16 |
| 1164859286 | Valarie Ranae Oldham | Physical Therapist | 827 E Main, Suite B, Blytheville, AR 72315 | 2013-10-03 |
| 1013350339 | Air Evac Ems Inc. | Ambulance | 1021 Highland Street, Blytheville, AR 72315 | 2013-04-17 |
| 1962707158 | Diffine Family Practice Pllc | Family Medicine | 1100 Medical Plaza Drive South, Suite C, Blytheville, AR 72315 | 2011-01-19 |
| 1447451984 | Diabetes Institute Inc | Durable Medical Equipment & Medical Supplies | 623 W Moultrie, Blytheville, AR 72315 | 2007-05-31 |
| 1043426109 | Connie Bromley | Social Worker | 514 Chickasawba, Blytheville, AR 72315 | 2007-05-15 |
| Find all providers in zip 72315 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497378004 | Vrf Eye Specialty Group, Plc | Ophthalmology | 1028 N Missouri St Ste 1, West Memphis, AR 72301-2600 | 2020-05-19 |
| 1215362397 | Lieblong Eye Center | Ophthalmology | 123 North Van Buren Street, Little Rock, AR 72205 | 2013-09-09 |
| 1417394404 | Hans Barron Heymann | Ophthalmology | 613 N Willow Ave, Fayetteville, AR 72701-3550 | 2013-05-30 |
| 1770821324 | Ernest Mitchell Singleton | Ophthalmology | 1793 E Manchester Dr, Fayetteville, AR 72703-6224 | 2013-01-16 |
| 1871810606 | Jennifer Ileen Doyle | Ophthalmology | 201 Executive Ct A, Little Rock, AR 72205-4536 | 2010-05-04 |
| 1265767990 | Magie Eye Clinic of Morrilton,pa | Ophthalmology | 810 E Harding St, Morrilton, AR 72110-2250 | 2009-10-14 |
| 1245468925 | Evan N Newbolt | Ophthalmology | 3805 West 28th Ave, Pine Bluff, AR 71603 | 2009-07-01 |
| 1336309657 | Billy Mitchell Chandler Sr. | Ophthalmology | 2916 Justin Matthews Dr, North Little Rock, AR 72116-8543 | 2008-06-10 |
| 1427215623 | Justin Lieblong | Ophthalmology | 123 North Van Buren, Little Rock, AR 72205 | 2008-05-16 |
| 1093988404 | Retina Specialists of Arkansas, P.a. | Ophthalmology | 5 Saint Vincent Cir Ste 201, Little Rock, AR 72205-5416 | 2008-04-07 |
| Find all providers with the same taxonomy | ||||
| City | BLYTHEVILLE |
| Zip Code | 72315 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.