Organization
VIRGINIA EYE CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY J WILSON O.D. (OWNER)
(434) 239-5323
Entity
Organization
Contact information
Practice address
2413 WARDS RD, LYNCHBURG, VA 24502-2103
(434) 239-5323
(434) 239-1388
Mailing address
2413 WARDS RD, LYNCHBURG, VA 24502-2103
(434) 239-5323
(434) 239-1388
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
06180000530
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9230122
—
VA
05
—
9234501
—
VA
Enumeration date
10/11/2006
Last updated
04/01/2013
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