Provider Demographics
NPI:1720146087
Name:NORFOLK EYE PHYSICIANS & SURGEONS LTD.
Entity Type:Organization
Organization Name:NORFOLK EYE PHYSICIANS & SURGEONS LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGAIL
Authorized Official - Middle Name:H
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-623-2123
Mailing Address - Street 1:1005 MAY AVENUE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504
Mailing Address - Country:US
Mailing Address - Phone:757-623-2123
Mailing Address - Fax:757-622-8806
Practice Address - Street 1:1005 MAY AVENUE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23504
Practice Address - Country:US
Practice Address - Phone:757-623-2123
Practice Address - Fax:757-622-8806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034703207W00000X
VA028180207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB08491Medicare UPIN
VAB07982Medicare UPIN