Provider Demographics
NPI:1538280086
Name:J. MICHAEL WEIL, P.C.
Entity Type:Organization
Organization Name:J. MICHAEL WEIL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WEIL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:757-497-1724
Mailing Address - Street 1:4554 VIRGINIA BEACH BLVD
Mailing Address - Street 2:STE 660
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3045
Mailing Address - Country:US
Mailing Address - Phone:757-497-1724
Mailing Address - Fax:757-499-2227
Practice Address - Street 1:4554 VIRGINIA BEACH BLVD
Practice Address - Street 2:STE 660
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3045
Practice Address - Country:US
Practice Address - Phone:757-497-1724
Practice Address - Fax:757-499-2227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000283152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty