Healthcare Provider Details

I. General information

NPI: 1235286402
Provider Name (Legal Business Name): OATMAN NILSEN & ASSOCIATES OPTOMETRISTS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 09/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N COURTHOUSE RD
RICHMOND VA
23236-4062
US

IV. Provider business mailing address

601 N COURTHOUSE RD
RICHMOND VA
23236-4062
US

V. Phone/Fax

Practice location:
  • Phone: 804-858-2020
  • Fax:
Mailing address:
  • Phone: 804-858-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618000736
License Number StateVA

VIII. Authorized Official

Name: DR. ERIC P. NILSEN
Title or Position: OWNER
Credential: O.D.
Phone: 804-858-2020