Provider Demographics
NPI:1104198456
Name:DR ROBIN M AYERS OD PC
Entity Type:Organization
Organization Name:DR ROBIN M AYERS OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:MCCLENNY
Authorized Official - Last Name:AYERS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:434-846-7877
Mailing Address - Street 1:PO BOX 851
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:24572-0851
Mailing Address - Country:US
Mailing Address - Phone:434-846-7877
Mailing Address - Fax:434-846-3215
Practice Address - Street 1:197 MADISON CIR STE 103
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:24572-2350
Practice Address - Country:US
Practice Address - Phone:434-846-7877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-02
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000612152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty