Provider Demographics
NPI:1598809048
Name:FORD, DAVID MARSHALL (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARSHALL
Last Name:FORD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4195
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39535-4195
Mailing Address - Country:US
Mailing Address - Phone:228-424-6264
Mailing Address - Fax:
Practice Address - Street 1:2600 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-4606
Practice Address - Country:US
Practice Address - Phone:228-388-8495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS620152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist