Healthcare Provider Details

I. General information

NPI: 1730263682
Provider Name (Legal Business Name): ON-CALL EYECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 08/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1982 ARLINGTON BLVD SUITE 2
CHARLOTTESVILLE VA
22903-1565
US

IV. Provider business mailing address

PO BOX 519
CROZET VA
22932-0519
US

V. Phone/Fax

Practice location:
  • Phone: 434-979-1698
  • Fax:
Mailing address:
  • Phone: 434-979-1698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number0618000364
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number0618000364
License Number StateVA

VIII. Authorized Official

Name: DR. DAVID CLAUSS
Title or Position: MANAGING MEMBER
Credential: O.D.
Phone: 434-979-1698