MEDICARE: DR. ANDREW V HORVATH 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	0618001639	VA
2	152W00000X	Optometrist		IL

General Provider Information

NPI Number	:	1447209929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW V HORVATH OD

Provider Business Mailing Address
First Line	:	301 NORTHWYND CIRCLE
Second Line	:	APT 906
City	:	LYNCHBURG
State	:	VA
Zip	:	24502
Country	:	US
Telephone Number	:
Fax Number	:	434-239-0220

Provider Business Practice Location Address
First Line	:	5049A VALLEY VIEW BLVD NW
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24012-2037
Country	:	US
Telephone Number	:	540-362-7565
Fax Number	:	540-563-0441

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	07/08/2007

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