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General NPI Number Information
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NPI Number | 1235467200
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Entity Type | Organization
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Legal Business Name | RALEIGH VISION ASSOCIATES
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Dates
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Enumeration Date | 12/02/2009
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Last Update Date | 12/02/2009
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Provider Practice Location Address
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Address Line | 1330 N. EISENHOWER DR.
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City | BECKLEY
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State | WV
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Zip | 25801-3156
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Country | US
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Telephone | 304-250-0336
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Fax | 304-250-0339
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Provider Business Mailing Address
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Address Line | 1330 N. EISENHOWER DR. RALEIGH VISION ASSOCIATES
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City | BECKLEY
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State | WV
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Zip | 25801-3156
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Country | US
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Telephone | 304-250-0336
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Fax | 304-250-0339
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID MICHAEL WATSON
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Credential | O.D.
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Telephone | 304-250-0336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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