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General NPI Number Information
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NPI Number | 1972614170
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Entity Type | Organization
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Legal Business Name | JONATHAN R NOBLE OD AND ASSOCIATES PLLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 04/06/2010
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Provider Practice Location Address
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Address Line | 145 HILL CARTER PKWY
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City | ASHLAND
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State | VA
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Zip | 23005-2327
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Country | US
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Telephone | 804-752-0188
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Fax | 804-752-0187
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Provider Business Mailing Address
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Address Line | 145 HILL CARTER PKWY
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City | ASHLAND
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State | VA
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Zip | 23005-2327
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Country | US
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Telephone | 804-752-0188
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Fax | 804-752-0187
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Authorized Official
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Title or Position | OWNER
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Name | DR. JONATHAN RICHARD NOBLE
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Credential | O.D.
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Telephone | 804-752-0188
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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 | 0618001153
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License Number State | VA
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