Healthcare Provider Details

I. General information

NPI: 1841370012
Provider Name (Legal Business Name): GERALD R NEIDIGH JR. O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14431 SOMMERVILLE CT STE B
MIDLOTHIAN VA
23113-6812
US

IV. Provider business mailing address

1404 N PARHAM RD STE F1
HENRICO VA
23229-5500
US

V. Phone/Fax

Practice location:
  • Phone: 804-888-8998
  • Fax:
Mailing address:
  • Phone: 804-353-3937
  • Fax: 804-358-1395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618000734
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: