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Organization
PIEDMONT OPHTHALMOLOGY CLINIC INC
Active
Organization
PIEDMONT OPHTHALMOLOGY CLINIC INC
Active
Other names
Dominion Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA H GAMMON (PRACTICE MANAGER)
(434) 799-3232
Entity
Organization
Contact information
Practice address
746 NE JENSEN BEACH BLVD, JENSEN BEACH, FL 34957-4754
(434) 250-6270
Mailing address
746 NE JENSEN BEACH BLVD, JENSEN BEACH, FL 34957-4754
(434) 250-6270
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080168
BCBS ANTHEM
VA
Enumeration date
08/24/2006
Last updated
03/24/2021
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