MEDICARE: EYE ASSOCIATES OF WINCHESTER INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician		VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477545051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE ASSOCIATES OF WINCHESTER INC.

Provider Business Mailing Address
First Line	:	136 LINDEN DR
Second Line	:	SUITE 104
City	:	WINCHESTER
State	:	VA
Zip	:	22601-6900
Country	:	US
Telephone Number	:	540-678-3588
Fax Number	:	540-678-9025

Provider Business Practice Location Address
First Line	:	1845 W PLAZA DR
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22601-6365
Country	:	US
Telephone Number	:	540-662-4512
Fax Number	:	540-722-5284

Authorized Official
Title or Position	:	M.D./OWNER
Name	:	NANCY B. EISELE
Credential	:	M.D.
Telephone Number	:	540-662-4512

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	01/07/2016

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