MEDICARE: DR. JERRY J DEOLA OD

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	0601000801	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093709594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERRY J DEOLA OD

Provider Business Mailing Address
First Line	:	4460 DALE BLVD
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22193-2534
Country	:	US
Telephone Number	:	703-670-8085
Fax Number	:

Provider Business Practice Location Address
First Line	:	4460 DALE BLVD
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22193-2534
Country	:	US
Telephone Number	:	703-670-8085
Fax Number	:

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

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	03/21/2014

Similar Medicare Providers

1437086998 — AMZ COLLECTIONS LLC
Practice Location Address:

14321 WESTWAY LN APT 1
WOODBRIDGE, VA
22193-2866

Practice Phone: 929-410-5754
Practice Fax: 929-410-5754

1740117035 — ETERNA CARE LLC
Practice Location Address:

13885 HEDGEWOOD DR STE 341
WOODBRIDGE, VA
22193-7933

Practice Phone: 571-235-0564
Practice Fax:

1841297090 — MR. DAVID W BOBB R.PH
Practice Location Address:

5302 MACDONALD RD
WOODBRIDGE, VA
22193-5885

Practice Phone: 571-285-3930
Practice Fax:

1831197177 — DR. ARNOLD STEVEN LEVIN D.P.M.
Practice Location Address:

4225 DALE BLVD
WOODBRIDGE, VA
22193-2243

Practice Phone: 703-670-9401
Practice Fax: 703-670-2065

1255330759 — DR. OSCAR FERNANDO SUGASTTI M.D.
Practice Location Address:

14009 MINNIEVILLE ROAD
WOODBRIDGE, VA
22193

Practice Phone: 703-580-6400
Practice Fax: 703-580-6402

1093708307 — DR. CHERYL A LOBO DDS
Practice Location Address:

4421 DALE BLVD STE 202
WOODBRIDGE, VA
22193-2550

Practice Phone: 703-680-2070
Practice Fax: 703-680-7722

Directions to “ DR. JERRY J DEOLA OD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.