Provider Demographics
NPI:1811907157
Name:WEST, DAVID ALAN SR (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALAN
Last Name:WEST
Suffix:SR
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 1:505 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ALTAVISTA
Mailing Address - State:VA
Mailing Address - Zip Code:24517-1815
Mailing Address - Country:US
Mailing Address - Phone:434-369-5092
Mailing Address - Fax:434-369-5092
Practice Address - Street 1:505 7TH ST
Practice Address - Street 2:
Practice Address - City:ALTAVISTA
Practice Address - State:VA
Practice Address - Zip Code:24517-1815
Practice Address - Country:US
Practice Address - Phone:434-369-5092
Practice Address - Fax:434-369-5092
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000527152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA090059OtherANTHEM BCBS
VA180006761OtherUNITED HEALTHCARE
VA116138OtherEYEMED
VA009205292Medicaid
VA116138OtherEYEMED
VA009205292Medicaid
VA0787560001Medicare NSC