Victor John Ford III, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

07829 Issued in MS

Practice address

1200 N State St Ste 330
Jackson, MS 39202

Phone

(601) 353-2020

Fax

(601) 714-5110

NPI assigned

Jun 17, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dr. V. John Ford III Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1073518817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST STE 330",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022027",
            "telephone_number": "601-353-2020",
            "fax_number": "601-714-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST STE 330",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39202",
            "telephone_number": "601-353-2020",
            "fax_number": "601-714-5110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1190 N State St",
            "address_2": "Ste 403",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392022413",
            "country_code": "US",
            "telephone_number": "601-353-2020 x138",
            "fax_number": "601-714-5110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1190 N State St",
            "address_2": "Ste 403",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392022413",
            "country_code": "US",
            "telephone_number": "601-353-2020 x138",
            "fax_number": "601-714-5110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORD",
        "first_name": "VICTOR",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MS",
            "license": "07829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009976285",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00122187",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1331163",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "V.",
            "last_name": "FORD",
            "middle_name": "JOHN",
            "prefix": "DR.",
            "suffix": "III",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Eden Ford, MSN, APRN, AGACNP-BC
• Joycelyn Ford
• Kayla Watts Ford
• Rachel Nichole Ford, WHNP
• Rodeirdre Ford, CMHT
• Jessica Renee Fordham, NP
• Shonvonyae Fordham
• Cali Foreman, LPC
• Jennifer Nichols Foreman, A-GNP-C
• Forest Avenue Opco, LLC

• Ophthalmology Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Ophthalmology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.