=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780897108
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WEST END OPHTHALMOLOGY,P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/08/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2010 JOHN ROLFE PARKWAY
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23238-8111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-740-7474
-----------------------------------------------------
Fax | 804-740-7475
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2010 JOHN ROLFE PARKWAY
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23238-8111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-740-7474
-----------------------------------------------------
Fax | 804-740-7475
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BUSINESS MANAGER
-----------------------------------------------------
Name | MRS. MEG H RUTHERFORD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 804-740-7474
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | 0101237542
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------