Organization
FORD VISION CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REAGAN L FORD SR. O.D. (DOCTOR/OWNER)
(662) 323-0571
Entity
Organization
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
02/07/2008
Last updated
10/07/2011
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