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General NPI Number Information
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NPI Number | 1043422314
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Entity Type | Organization
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Legal Business Name | BLUE RIDGE EYE SPECIALISTS PC
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 420 W JUBAL EARLY DR SUITE 200
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City | WINCHESTER
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State | VA
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Zip | 22601-6434
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Country | US
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Telephone | 540-662-2700
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Fax | 540-662-8801
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Provider Business Mailing Address
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Address Line | 420 W JUBAL EARLY DR SUITE 200
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City | WINCHESTER
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State | VA
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Zip | 22601-6434
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Country | US
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Telephone | 540-662-2700
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Fax | 540-662-8801
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALAN J FINK
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Credential | M.D.
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Telephone | 540-662-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 0101040914
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License Number State | VA
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