Healthcare Provider Details

I. General information

NPI: 1508781337
Provider Name (Legal Business Name): NATIONAL VISION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 N VERRADO WAY
BUCKEYE AZ
85396
US

IV. Provider business mailing address

2000 NEWPOINT PKWY
LAWRENCEVILLE GA
30043-5577
US

V. Phone/Fax

Practice location:
  • Phone: 602-333-0552
  • Fax:
Mailing address:
  • Phone: 800-571-5202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: LEAHANN RENE VAUGHN
Title or Position: MANAGED CARE DIRECTOR
Credential:
Phone: 404-775-9182