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General NPI Number Information
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NPI Number | 1770990376
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Entity Type | Organization
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Legal Business Name | ADVANCED VISION SURGERY CENTER LLC
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Dates
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Enumeration Date | 07/15/2014
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 5215 MONTICELLO AVE
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-8213
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Country | US
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Telephone | 757-229-4000
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Fax | 757-220-2798
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Provider Business Mailing Address
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Address Line | 2010 BREMO RD STE 128A
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City | RICHMOND
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State | VA
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Zip | 23226-2444
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Country | US
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Telephone | 877-969-0392
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Fax | 757-220-2798
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Authorized Official
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Title or Position | CREDENTIALING
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Name | MRS. AMY BURTON
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Credential |
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Telephone | 434-661-7762
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State | VA
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