Healthcare Provider Details

I. General information

NPI: 1932425212
Provider Name (Legal Business Name): DR. NORMAN M. KAHN, O.D., P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 04/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17835 FOREST RD SUITE B
FOREST VA
24551-4043
US

IV. Provider business mailing address

17835 FOREST RD SUITE B
FOREST VA
24551-4043
US

V. Phone/Fax

Practice location:
  • Phone: 434-385-8855
  • Fax: 434-385-7575
Mailing address:
  • Phone: 434-385-8855
  • Fax: 434-385-7575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number0618000177
License Number StateVA

VIII. Authorized Official

Name: DR. NORMAN M KAHN
Title or Position: DOCTOR OF OPTOMETRY
Credential: O.D.
Phone: 434-384-3887