Provider Demographics
NPI:1851481840
Name:A. GREGORY TOLER JR/ALAN G TOLER OD PTNR
Entity Type:Organization
Organization Name:A. GREGORY TOLER JR/ALAN G TOLER OD PTNR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CALL
Authorized Official - Suffix:
Authorized Official - Credentials:CPOA
Authorized Official - Phone:804-231-9151
Mailing Address - Street 1:1407 WESTOVER HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-3109
Mailing Address - Country:US
Mailing Address - Phone:804-231-9151
Mailing Address - Fax:804-231-9175
Practice Address - Street 1:1407 WESTOVER HILLS BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-3109
Practice Address - Country:US
Practice Address - Phone:804-231-9151
Practice Address - Fax:804-231-9175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000188152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2200104OtherUNITED HEALTHCARE
VA5072484OtherCIGNA
VA068258OtherANTHEM
VA068261OtherANTHEM
VA2200139OtherUNITED HEALTHCARE
VA009200134Medicaid
VA009242589Medicaid
VA068257OtherANTHEM
VA436188OtherMAMSI
VA068260OtherANTHEM
VA068261OtherANTHEM
VA410000391Medicare ID - Type Unspecified
VA009200134Medicaid
VA068258OtherANTHEM
VA410019925Medicare ID - Type Unspecified
VA436188OtherMAMSI
VA068260OtherANTHEM
VAT21890Medicare UPIN
VA410000712Medicare ID - Type Unspecified
VA068257OtherANTHEM