Provider Demographics
NPI:1043422314
Name:BLUE RIDGE EYE SPECIALISTS PC
Entity Type:Organization
Organization Name:BLUE RIDGE EYE SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:FINK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-662-2700
Mailing Address - Street 1:420 W JUBAL EARLY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6434
Mailing Address - Country:US
Mailing Address - Phone:540-662-2700
Mailing Address - Fax:540-662-8801
Practice Address - Street 1:420 W JUBAL EARLY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6434
Practice Address - Country:US
Practice Address - Phone:540-662-2700
Practice Address - Fax:540-662-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040914207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09356Medicare PIN