Provider Demographics
NPI:1366448144
Name:VILLA, FRANK BENEDICT II (OD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:BENEDICT
Last Name:VILLA
Suffix:II
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18800 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-4494
Mailing Address - Country:US
Mailing Address - Phone:434-385-8800
Mailing Address - Fax:
Practice Address - Street 1:18800 FOREST RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-4494
Practice Address - Country:US
Practice Address - Phone:434-385-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-25
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000190152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI410037410OtherRAIL ROAD MEDICARE
VA9230084Medicaid
VA0139570001OtherADMINA STAR
VA260837OtherANTHEM
VA260837OtherANTHEM
410001053Medicare PIN