Provider Demographics
NPI:1235286402
Name:OATMAN NILSEN & ASSOCIATES OPTOMETRISTS LTD
Entity Type:Organization
Organization Name:OATMAN NILSEN & ASSOCIATES OPTOMETRISTS LTD
Other - Org Name:DR. ERIC NILSEN AND ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:P
Authorized Official - Last Name:NILSEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:804-858-2020
Mailing Address - Street 1:601 N COURTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23236-4062
Mailing Address - Country:US
Mailing Address - Phone:804-858-2020
Mailing Address - Fax:
Practice Address - Street 1:601 N COURTHOUSE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23236-4062
Practice Address - Country:US
Practice Address - Phone:804-858-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000736152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA196402OtherANTHEM BCBS
VAC10272Medicare PIN