Healthcare Provider Details

I. General information

NPI: 1881770063
Provider Name (Legal Business Name): VISION PLUS OF DE P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CHRISTIANA MEDICAL CTR
NEWARK DE
19702-1697
US

IV. Provider business mailing address

100 CHRISTIANA MEDICAL CTR
NEWARK DE
19702-1697
US

V. Phone/Fax

Practice location:
  • Phone: 302-283-1988
  • Fax: 302-283-1991
Mailing address:
  • Phone: 302-283-1988
  • Fax: 302-283-1991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number1132
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number1132
License Number StateDE

VIII. Authorized Official

Name: DR. ALTON A WILLIAMS
Title or Position: DR OF OPTOMETRY CHAIRMAN
Credential: OD
Phone: 302-283-1988