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Organization
MID SOUTH RETINA ASSOCIATES LLC
Active
Organization
MID SOUTH RETINA ASSOCIATES LLC
Active
Parent organization
MID SOUTH RETINA ASSOCIATES, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MID SOUTH RETINA ASSOCIATES, LLC
Authorized official
DR. RICHARD SIEVERS M.D. (PARTNER)
(901) 682-1100
Entity
Organization
Contact information
Practice address
201 ALCORN DR, CORINTH, MS 38834-8400
(662) 287-7111
Mailing address
PO BOX 1000 DEPT 448, MEMPHIS, TN 38148-0448
(901) 682-1100
(901) 682-6915
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04635763
—
MS
01
—
465151795
AHS STATE OF MS BC
MS
01
—
465151795B
BLUE CROSS OF MISSISSIPPI
MS
Enumeration date
06/18/2006
Last updated
07/21/2025
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