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NPI Code Detail

MEDICARE: GAINESVILLE EYE ASSOCIATES, LLC

MEDICARE: GAINESVILLE EYE ASSOCIATES, LLC
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
1207W00000XOphthalmology Physician0101239485VA

General Provider Information

NPI Number : 1356518849
Entity Type Code : Organization
Provider Name (Legal Business Name) : GAINESVILLE EYE ASSOCIATES, LLC
Provider Business Mailing Address
First Line : 7300 HERITAGE VILLAGE PLZ
Second Line :
City : GAINESVILLE
State : VA
Zip : 20155-3079
Country : US
Telephone Number : 703-753-4733
Fax Number :
Provider Business Practice Location Address
First Line : 7300 HERITAGE VILLAGE PLZ
Second Line :
City : GAINESVILLE
State : VA
Zip : 20155-3079
Country : US
Telephone Number : 703-753-4733
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. PHILIP RYONG CHUNG
Credential : M.D.
Telephone Number : 703-753-4733
Provider Enumeration Date : 05/13/2008
Last Update Date : 05/14/2008

Similar Medicare Providers

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Practice Location Address:
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Practice Fax:
1952982225 — COMMUNITY CARE NETWORKS
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1801748819 — MRS. JENNA HAZEL MCBRIDE
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Practice Fax:

Directions to “GAINESVILLE EYE ASSOCIATES, LLC ” Practice Location

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