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Organization
MID-SOUTH RETINA ASSOCIATES, LLC
Active
Organization
MID-SOUTH RETINA ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD ERVIN SIEVERS M.D. (PRESIDENT)
(901) 682-1100
Entity
Organization
Contact information
Practice address
1804 E SHILOH RD, CORINTH, MS 38834-3637
(731) 427-7799
(731) 427-1476
Mailing address
6005 PARK AVE, SUITE 624B, MEMPHIS, TN 38119-5202
(901) 682-1100
(901) 682-6915
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
18267
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04635763
—
MS
Enumeration date
07/26/2007
Last updated
04/20/2008
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