# MID SOUTH RETINA ASSOCIATES LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MID SOUTH RETINA ASSOCIATES, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1598700254
- **Legal business name:** MID SOUTH RETINA ASSOCIATES, LLC
- **Authorized official:** DR. RICHARD SIEVERS M.D. (PARTNER)
- **Authorized official phone:** (901) 682-1100

## Contact information

- **Practice address:** 201 ALCORN DR, CORINTH, MS 38834-8400
- **Practice address phone:** (662) 287-7111
- **Mailing address:** PO BOX 1000 DEPT 448, MEMPHIS, TN 38148-0448
- **Mailing address phone:** (901) 682-1100
- **Mailing address fax:** (901) 682-6915

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/18/2006
- **Last updated:** 07/21/2025

## 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 |