Provider Demographics
NPI:1801100813
Name:NICHOLAS, RICHARD ANDREW (OD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ANDREW
Last Name:NICHOLAS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 KILGORE AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2057
Mailing Address - Country:US
Mailing Address - Phone:757-825-1849
Mailing Address - Fax:
Practice Address - Street 1:4700 KILGORE AVE
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2057
Practice Address - Country:US
Practice Address - Phone:757-825-1849
Practice Address - Fax:757-827-3261
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001947152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist