Provider Demographics
NPI:1578946232
Name:SAXTON, AUSRA ELENA (OD)
Entity Type:Individual
Prefix:DR
First Name:AUSRA
Middle Name:ELENA
Last Name:SAXTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:AUSRA
Other - Middle Name:
Other - Last Name:CLIFFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3575 BRIDGE RD STE 21
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-1845
Mailing Address - Country:US
Mailing Address - Phone:757-638-2015
Mailing Address - Fax:757-638-2010
Practice Address - Street 1:3575 BRIDGE RD STE 21
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-1845
Practice Address - Country:US
Practice Address - Phone:757-638-2015
Practice Address - Fax:757-638-2010
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002472152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1578946232Medicaid