Provider Demographics
NPI:1164684775
Name:NEW VISIONS INC.
Entity Type:Organization
Organization Name:NEW VISIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:SHIVERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:912-638-1999
Mailing Address - Street 1:267 N HARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:ST SIMONS ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31522-5341
Mailing Address - Country:US
Mailing Address - Phone:912-230-0030
Mailing Address - Fax:
Practice Address - Street 1:2927 DEMERE RD
Practice Address - Street 2:
Practice Address - City:ST SIMONS ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31522-1620
Practice Address - Country:US
Practice Address - Phone:912-638-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0302142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD41106Medicare UPIN