MEDICARE: DR. AUKSE WIRZ O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	0618000338	VA

General Provider Information

NPI Number	:	1013160795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUKSE WIRZ O.D.

Provider Business Mailing Address
First Line	:	2275 DARLEY DR
Second Line	:
City	:	POWHATAN
State	:	VA
Zip	:	23139-6249
Country	:	US
Telephone Number	:	804-739-7452
Fax Number	:

Provider Business Practice Location Address
First Line	:	13400 TREDEGAR LAKE PKWY
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23112-4070
Country	:	US
Telephone Number	:	804-739-3221
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	01/21/2020

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