Provider Demographics
NPI:1255676292
Name:DR. M. STANLEY LANWAY & ASSOCIATES
Entity Type:Organization
Organization Name:DR. M. STANLEY LANWAY & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MERLE
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:LANWAY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:703-971-7722
Mailing Address - Street 1:6575 FRONTIER DR
Mailing Address - Street 2:SUITE N
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-1415
Mailing Address - Country:US
Mailing Address - Phone:703-971-7722
Mailing Address - Fax:703-971-1724
Practice Address - Street 1:6575 FRONTIER DR
Practice Address - Street 2:SUITE N
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-1415
Practice Address - Country:US
Practice Address - Phone:703-971-7722
Practice Address - Fax:703-971-1724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000503152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty