Join Us!
BECOME A DAVIS VISION DOCTOR
With over 50 years’ experience in
the vision industry and 22 million members, Davis Vision’s client base and
membership continues to grow, driving volume and increasing exposure to the
providers in our network. More than 98% of Davis Vision members use
in-network providers for their eye care needs.
Complete the form below to begin the
process. A member of our team will be in contact with you.
Davis Vision Provider Participant Form
Fill out this form requesting to become a Davis Vision Provider
Reason for Submission
Services Offered
Profession
Practitioner's Name (Last, First)
*Note: If listing multiple practitioners, please list additional practitioner names and CAQH numbers within the "Additional Information" box at the bottom of the page.
Email
Phone Number
Primary Office Location
DBA Name
Street Address
City
State
Zip Code
Is this a current Davis Vision location?
(if "Yes", type Davis Vision provider number)
Adding Multiple Offices?
Retail Affiliation
(if "Yes", type affiliate name)
Do you currently maintain your credentialing documents through CAQH?
(if "Yes", type CAQH number)
Individual NPI
Group NPI
Additional Information
*Note: If listing multiple practitioners,
please list additional practitioner names and CAQH numbers within the
box below.
If you are already a Davis Vision provider and need to make changes to your existing account, please contact our Provider Relations Representatives at 1.800.933.9371 for assistance.