RETINA INSTITUTE OF MISSISSIPPI (NPI# 1255974309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255974309 |
| Entity Type | Organization |
| Organization Name | RETINA INSTITUTE OF MISSISSIPPI |
| Practice Address |
971 Lakeland Dr Ste 657 Jackson MS 39216-4608 |
| Mailing Address |
344 Sundial Rd Madison MS 39110-8772 |
| Practice Telephone | 4095539058 |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2019-10-22 |
| Authorized Official Name | DR. BRIAN CUONG TIEU (OWNER) |
| Authorized Official Telephone | 4095539058 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
Allopathic & Osteopathic Physicians |
| Street Address |
971 LAKELAND DR STE 657 |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-4608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639176472 | Vern Antoine Keller | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 971 Lakeland Dr Ste 657, Jackson, MS 39216-4608 | 2005-07-07 |
| 1538518519 | Melanie Elizabeth Furr | Physician Assistant | 971 Lakeland Dr Ste 657, Jackson, MS 39216-4608 | 2016-06-09 |
| 1689725202 | Ronald Kennedy | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 971 Lakeland Dr Ste 657, Jackson, MS 39216-4608 | 2007-01-12 |
| 1518992833 | Ronald Eller | Physician Assistant | 971 Lakeland Dr Ste 657, Jackson, MS 39216-4608 | 2006-07-12 |
| 1386639359 | Eric T Lenoir | Physician Assistant | 971 Lakeland Dr Ste 657, Jackson, MS 39216-4608 | 2005-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 207WX0107X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Retina Specialist |
| An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. |
| Notes: Source: American Society of Retina Specialists, www.asrs.org [1/1/2017: new] - Additional Resources: American Academy of Ophthalmology, www.aao.org. Macula Society, www.maculasociety.org. Retina Society, www.retinasociety.org. Association of University Professors of Ophthalmology, www.aupo.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225449317 | David Kilpatrick | Ophthalmology | 1200 N State St Ste 300, Jackson, MS 39202-2027 | 2014-05-12 |
| 1962780023 | Brian C. Tieu | Ophthalmology | 2500 N State St, Jackson, MS 39216-4500 | 2011-07-22 |
| 1669760385 | Albert L. Lin | Ophthalmology | 2500 N State St, Jackson, MS 39216 | 2011-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427511880 | Deep Blue Retina, Pllc | Ophthalmology | 7900 Airways Blvd Bldg A1, Southaven, MS 38671-4116 | 2019-04-11 |
Please comment or provide details below to improve the information on RETINA INSTITUTE OF MISSISSIPPI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.