Provider Demographics
NPI:1497812580
Name:VIRGINIA OPHTHALMOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:VIRGINIA OPHTHALMOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:W
Authorized Official - Last Name:REDA
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:2007-01-02
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0716170001OtherMEDICARE DME