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General NPI Number Information
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NPI Number | 1548200280
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Entity Type | Organization
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Legal Business Name | CHARLOTTESVILLE EYE ASSOCIATES LTD
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 110 S PANTOPS DR
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-8672
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Country | US
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Telephone | 434-977-5160
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Fax | 434-977-5202
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Provider Business Mailing Address
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Address Line | 110 S PANTOPS DR
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-8672
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Country | US
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Telephone | 434-977-5160
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Fax | 434-977-5202
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Authorized Official
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Title or Position | FINANCIAL MANAGER
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Name | DR. RICHARD W. MORTON
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Credential | M.D.
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Telephone | 434-977-5160
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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 | 0101038523
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License Number State | VA
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