Healthcare Provider Details

I. General information

NPI: 1063366326
Provider Name (Legal Business Name): NATIONAL VISION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2026
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3360 N AVE
TINKER AFB OK
73145-9028
US

IV. Provider business mailing address

2435 COMMERCE AVE BLDG 2200
DULUTH GA
30096-4980
US

V. Phone/Fax

Practice location:
  • Phone: 405-732-7484
  • Fax:
Mailing address:
  • Phone: 470-448-2092
  • Fax: 470-448-2092

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