Delta Vision Clinic Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

651 Issued in MS

Legal business name

DELTA VISION CLINIC INC

Doing business as

EyeDeal Optical

Practice address

2119 Highway 82 E
Greenville, MS 38703-6010

Phone

(662) 332-3325

Fax

(662) 378-3325

NPI assigned

Feb 2, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Reagan Lee Ford II, O.D.

Title

Owner

Phone

(662) 332-3325

Specialties & licenses 1

Addresses

Other names 1

• EyeDeal Optical Doing business as

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720126592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 HIGHWAY 82 E",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387036010",
            "telephone_number": "662-332-3325",
            "fax_number": "662-378-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 HIGHWAY 82 E",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387036010",
            "telephone_number": "662-332-3325",
            "fax_number": "662-378-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA VISION CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "REAGAN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-332-3325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EyeDeal Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Greenville, MS
• Providers in Greenville, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.