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. WILLIAM PRIESTER M.D. (PARTNER)
(901) 682-1100
Entity
Organization
Contact information
Practice address
609 SKYLINE DR, JACKSON, TN 38301-3911
(731) 427-7799
(731) 427-1476
Mailing address
PO BOX 1000 DEPT 448, MEMPHIS, TN 38148-0448
(731) 427-7799
(731) 427-1476
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3104352
BLUE CROSS OF TENNESSEE
TN
05
—
3812364
—
TN
05
—
3886759
—
TN
01
—
4067262
BLUE CROSS OF TENNESSEE
TN
Enumeration date
06/25/2006
Last updated
08/05/2025
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