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NPI Code Detail

MEDICARE: DR. WILLIAM DODGE PERRY O.D.

MEDICARE: DR. WILLIAM DODGE PERRY 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
1152W00000XOptometrist0618001754VA

General Provider Information

NPI Number : 1730340209
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM DODGE PERRY O.D.
Provider Business Mailing Address
First Line : 5653 COLUMBIA PIKE STE 101
Second Line :
City : BAILEYS CROSSROADS
State : VA
Zip : 22041-2874
Country : US
Telephone Number : 703-578-3600
Fax Number : 703-379-6089
Provider Business Practice Location Address
First Line : 5653 COLUMBIA PIKE STE 101
Second Line :
City : BAILEYS CROSSROADS
State : VA
Zip : 22041-2874
Country : US
Telephone Number : 703-578-3600
Fax Number : 703-379-6089
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2008
Last Update Date : 06/18/2008

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