Provider Demographics
NPI:1275588477
Name:VIRGINIA OPHTHALMOLOGY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:VIRGINIA OPHTHALMOLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:LALL-TRAIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-461-1444
Mailing Address - Street 1:885 KEMPSVILLE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3800
Mailing Address - Country:US
Mailing Address - Phone:757-461-1444
Mailing Address - Fax:757-461-8238
Practice Address - Street 1:885 KEMPSVILLE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3800
Practice Address - Country:US
Practice Address - Phone:757-461-1444
Practice Address - Fax:757-461-8238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA010131877207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty