Individual
DR. REAGAN LEE FORD SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
706F HIGHWAY 12 W, STARKVILLE, MS 39759-3573
(662) 323-0571
(662) 323-6365
Mailing address
706F HIGHWAY 12 W, STARKVILLE, MS 39759-3573
(662) 323-0571
(662) 323-6365
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
466
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087840
—
MS
Enumeration date
07/20/2006
Last updated
07/08/2007
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