Provider Demographics
NPI:1386824399
Name:EASTERN VIRGINIA EYE ASSOCIATES, PC
Entity Type:Organization
Organization Name:EASTERN VIRGINIA EYE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:SWATTS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:757-436-3937
Mailing Address - Street 1:1108 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-7102
Mailing Address - Country:US
Mailing Address - Phone:757-436-3937
Mailing Address - Fax:757-436-3209
Practice Address - Street 1:1249 CEDAR RD
Practice Address - Street 2:SUITE 104
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-7292
Practice Address - Country:US
Practice Address - Phone:757-436-3937
Practice Address - Fax:757-436-3209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC08799Medicare PIN