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NPI 1164376901

NPI 1164376901 : NATIONAL VISION, INC. : TIFTON, GA

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General NPI Number Information
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    NPI Number           |    1164376901
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    Entity Type          |    Organization 
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    Legal Business Name  |    NATIONAL VISION, INC. 
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Dates
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    Enumeration Date     |    02/26/2026
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    Last Update Date     |    02/26/2026
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Provider Practice Location Address
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    Address Line         |    1430 US HIGHWAY 82 W 
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    City                 |    TIFTON
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    State                |    GA
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    Zip                  |    31793-8011
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    Country              |    US
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    Telephone            |    229-479-7378
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2435 COMMERCE AVE BLDG 2200 
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    City                 |    DULUTH
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    State                |    GA
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    Zip                  |    30096-4980
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    Country              |    US
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    Telephone            |    470-448-2092
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    Fax                  |    470-448-2092
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Authorized Official
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    Title or Position    |    MANAGED CARE DIRECTOR
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    Name                 |     LEAHANN RENE VAUGHN 
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    Credential           |    
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    Telephone            |    404-775-9182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    
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    License Number State |    
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