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NPI Code Detail

MEDICARE: DR. JONATHAN RICHARD NOBLE O.D.

MEDICARE: DR. JONATHAN RICHARD NOBLE O.D.
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
1152W00000XOptometrist0618001153VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1266832OTHERVAANTHEM
2171918OTHERVAANTHEM
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639126600
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN RICHARD NOBLE O.D.
Provider Business Mailing Address
First Line : 3855 GASKINS RD
Second Line :
City : HENRICO
State : VA
Zip : 23233-1441
Country : US
Telephone Number : 804-290-4278
Fax Number : 804-217-6400
Provider Business Practice Location Address
First Line : 3855 GASKINS RD
Second Line :
City : HENRICO
State : VA
Zip : 23233-1441
Country : US
Telephone Number : 804-290-4278
Fax Number : 804-217-6400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2006
Last Update Date : 11/02/2020

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