Provider Demographics
NPI:1033242219
Name:NORFOLK EYE PHYSICIANS & SURGEONS
Entity Type:Organization
Organization Name:NORFOLK EYE PHYSICIANS & SURGEONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGAIL
Authorized Official - Middle Name:H
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-623-2123
Mailing Address - Street 1:1005 MAY AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504-3423
Mailing Address - Country:US
Mailing Address - Phone:757-623-2123
Mailing Address - Fax:757-622-8806
Practice Address - Street 1:1005 MAY AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504-3423
Practice Address - Country:US
Practice Address - Phone:757-623-2123
Practice Address - Fax:757-622-8806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034703332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC00740Medicare ID - Type Unspecified