Provider Demographics
NPI:1376634014
Name:CENTRAL VIRGINIA EYE SPECIALISTS
Entity Type:Organization
Organization Name:CENTRAL VIRGINIA EYE SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:CAMPANA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:804-740-1338
Mailing Address - Street 1:7702 E PARHAM RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4371
Mailing Address - Country:US
Mailing Address - Phone:804-740-1338
Mailing Address - Fax:804-523-4286
Practice Address - Street 1:7702 E PARHAM RD
Practice Address - Street 2:SUITE 203
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4371
Practice Address - Country:US
Practice Address - Phone:804-740-1338
Practice Address - Fax:804-523-4286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA06180000288152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU06596Medicare UPIN
VAC09574Medicare PIN