Healthcare Provider Details
I. General information
NPI: 1992727820
Provider Name (Legal Business Name): VIRGINIA EYE CONSULTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/23/2006
Last Update Date: 03/27/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
241 CORPORATE BLVD STE 210
NORFOLK VA
23502-4965
US
IV. Provider business mailing address
241 CORPORATE BLVD
NORFOLK VA
23502
US
V. Phone/Fax
- Phone: 757-622-2200
- Fax: 757-622-4866
- Phone: 757-622-2200
- Fax: 757-622-4866
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSEPH
GIRA
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 636-200-4393