Provider Demographics
NPI:1881770063
Name:VISION PLUS OF DE P A
Entity type:Organization
Organization Name:VISION PLUS OF DE P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR OF OPTOMETRY CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALTON
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:302-283-1988
Mailing Address - Street 1:100 CHRISTIANA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-1697
Mailing Address - Country:US
Mailing Address - Phone:302-283-1988
Mailing Address - Fax:302-283-1991
Practice Address - Street 1:100 CHRISTIANA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-1697
Practice Address - Country:US
Practice Address - Phone:302-283-1988
Practice Address - Fax:302-283-1991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1132332H00000X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE410037570OtherRAILROAD MEDICARE
DE0000701922Medicaid
DE4032050001Medicare NSC
DEG02833Medicare PIN
DE410037570OtherRAILROAD MEDICARE