Provider Demographics
NPI:1093139230
Name:DR GREGORY M SCHULTZ OD PC
Entity Type:Organization
Organization Name:DR GREGORY M SCHULTZ OD PC
Other - Org Name:EYE CENTER OF VIRGINIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TESS
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-229-1131
Mailing Address - Street 1:101 TEWNING RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2639
Mailing Address - Country:US
Mailing Address - Phone:757-229-1131
Mailing Address - Fax:757-229-1586
Practice Address - Street 1:101 TEWNING RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2639
Practice Address - Country:US
Practice Address - Phone:757-229-1131
Practice Address - Fax:757-229-1586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001377152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty