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NPI Code Detail

MEDICARE: DR. WILLIAM FLETCHER DAMRON OD

MEDICARE:  DR. WILLIAM FLETCHER DAMRON  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
1152W00000XOptometrist0618000258VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
191431OTHERVAOPTIMA
2178557OTHERVAANTHEM BCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194747782
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM FLETCHER DAMRON OD
Provider Business Mailing Address
First Line : 226 FORT LN
Second Line :
City : PORTSMOUTH
State : VA
Zip : 23704-2220
Country : US
Telephone Number : 757-393-6131
Fax Number : 757-393-0976
Provider Business Practice Location Address
First Line : 226 FORT LN
Second Line :
City : PORTSMOUTH
State : VA
Zip : 23704-2220
Country : US
Telephone Number : 757-393-6131
Fax Number : 757-393-0976
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2006
Last Update Date : 06/30/2009

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Directions to “ DR. WILLIAM FLETCHER DAMRON OD” Practice Location

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