Join Us!

BECOME A DAVIS VISION DOCTOR

With over 50 years’ experience in the vision industry and 21 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
(Select) OD MD DO Optician

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
(Select) Alabama Alaska American Samoa Arizona Arkansas Armed Forces Americas (except Canada) Armed Forces Europe, Canada, Africa, Middle East Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Federated States Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming

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.