Provider Demographics
NPI:1982482170
Name:ABSHIRE, NORMAN TALBERT JR (LICENSED OPTICIAN)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:TALBERT
Last Name:ABSHIRE
Suffix:JR
Gender:M
Credentials:LICENSED OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 COMMONWEALTH DR
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-1169
Mailing Address - Country:US
Mailing Address - Phone:276-228-4484
Mailing Address - Fax:
Practice Address - Street 1:345 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382
Practice Address - Country:US
Practice Address - Phone:540-498-8638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156FX1800X
VA1101001709156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician