Provider Demographics
NPI:1245429372
Name:SOUTHERN VIRGINIA EYE CARE, INC.
Entity Type:Organization
Organization Name:SOUTHERN VIRGINIA EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D./CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:SILVERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-666-2020
Mailing Address - Street 1:1103 BROOKDALE ST STE D
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-4531
Mailing Address - Country:US
Mailing Address - Phone:276-666-2020
Mailing Address - Fax:276-666-5993
Practice Address - Street 1:1103 BROOKDALE ST STE D
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-4531
Practice Address - Country:US
Practice Address - Phone:276-666-2020
Practice Address - Fax:276-666-5993
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHERN VIRGINIA EYE CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052812174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG08125Medicare UPIN