# WEST VIRGINIA RETINA INSTITUTE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205703329
- **Authorized official:** DANIEL RUSSELL RICHARDSON MD (MEMBER)
- **Authorized official phone:** (229) 402-5869

## Contact information

- **Practice address:** 333 LAIDLEY ST STE 208, CHARLESTON, WV 25301-1614
- **Practice address phone:** (304) 935-0014
- **Mailing address:** PO BOX 70100, CHARLESTON, WV 25301-0100
- **Mailing address phone:** (229) 402-5869

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | NULL | Yes |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/22/2025
- **Last updated:** 12/03/2025