MEDICARE: DR. KARMEN M HOLDINGHAUSEN 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	2528	TN
2	152W00000X	Optometrist	0618003082	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
2	4092572	OTHER	TN	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124028097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARMEN M HOLDINGHAUSEN OD

Provider Business Mailing Address
First Line	:	2010 BREMO RD STE 128A
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23226-2444
Country	:	US
Telephone Number	:	877-969-0392
Fax Number	:	434-455-7172

Provider Business Practice Location Address
First Line	:	1825 GRAVES MILL RD
Second Line	:
City	:	FOREST
State	:	VA
Zip	:	24551-3967
Country	:	US
Telephone Number	:	434-385-5600
Fax Number	:

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	11/12/2021

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