Provider Demographics
NPI: | 1821611435 |
---|---|
Name: | VRF EYE SPECIALTY GROUP, PLC |
Entity Type: | Organization |
Organization Name: | VRF EYE SPECIALTY GROUP, PLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | THOMAS |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BROWN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 901-685-2200 |
Mailing Address - Street 1: | PO BOX 22510 |
Mailing Address - Street 2: | |
Mailing Address - City: | JACKSON |
Mailing Address - State: | MS |
Mailing Address - Zip Code: | 39225-2510 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 901-685-2200 |
Mailing Address - Fax: | 901-255-5631 |
Practice Address - Street 1: | 325C N SEBASTIAN |
Practice Address - Street 2: | |
Practice Address - City: | WEST HELENA |
Practice Address - State: | AR |
Practice Address - Zip Code: | 72390-2417 |
Practice Address - Country: | US |
Practice Address - Phone: | 870-572-7886 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-05-19 |
Last Update Date: | 2020-05-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Multi-Specialty | |
No | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | Group - Multi-Specialty |