Provider Demographics
NPI:1043305717
Name:KRISHNA SANKAR M.D., P.C.
Entity Type:Organization
Organization Name:KRISHNA SANKAR M.D., P.C.
Other - Org Name:ALLEGHANY OPTICIAN OPTICIAL DIVISION OF KRISHNA SANKAR M.D.,P.C.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-962-4710
Mailing Address - Street 1:201 INTERSTATE DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24426-6441
Mailing Address - Country:US
Mailing Address - Phone:540-962-4710
Mailing Address - Fax:540-962-7573
Practice Address - Street 1:201 INTERSTATE DR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24426-6441
Practice Address - Country:US
Practice Address - Phone:540-962-4710
Practice Address - Fax:540-962-7573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAP063015332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009206698Medicaid
VA009280804Medicaid
VA006304931Medicaid
VA006304931Medicaid
VA5449700001Medicare NSC