Organization
MID SOUTH VISION CENTER PLLC
Active
Other names
Stephen R Davis OD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN R DAVIS O.D. (OPTOMETRIST)
(901) 373-4207
Entity
Organization
Contact information
Practice address
6025 STAGE RD STE 44, BARTLETT, TN 38134-8374
(901) 373-4207
(901) 373-4208
Mailing address
6025 STAGE RD STE 44, BARTLETT, TN 38134-8374
(901) 373-4207
(901) 373-4208
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TN611
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004616972
AETNA
TN
01
—
0197238
TN CARE SELECT
TN
01
—
1765406
CIGNA
TN
Enumeration date
06/03/2008
Last updated
12/03/2018
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