Individual
DR. JOHN R. MIKSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5419 PATTERSON AVE, RICHMOND, VA 23226-2003
(804) 285-7638
(804) 285-2107
Mailing address
5419 PATTERSON AVE, RICHMOND, VA 23226-2003
(804) 285-7638
(804) 285-2107
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0601001234
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG2865
MEDICARE RAILROAD
VA
Enumeration date
11/04/2005
Last updated
05/05/2014
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