Provider Demographics
NPI:1881655058
Name:JAMES RIVER EYE PHYSICIANS PC
Entity Type:Organization
Organization Name:JAMES RIVER EYE PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCKEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD MS
Authorized Official - Phone:757-595-8404
Mailing Address - Street 1:704 THIMBLE SHOALS BLVD
Mailing Address - Street 2:#100
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606
Mailing Address - Country:US
Mailing Address - Phone:757-595-8404
Mailing Address - Fax:757-595-8353
Practice Address - Street 1:704 THIMBLE SHOALS BLVD
Practice Address - Street 2:#100
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606
Practice Address - Country:US
Practice Address - Phone:757-595-8404
Practice Address - Fax:757-595-8353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C05713Medicare ID - Type UnspecifiedGROUP PRACTICE