Organization
OPHTHALMOLOGY AND RETINA ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTYN BILLINGS (CREDENTIALING)
(412) 655-4362
Entity
Organization
Contact information
Practice address
1500 LAFAYETTE AVE, MOUNDSVILLE, WV 26041-2345
(304) 845-0908
Mailing address
PO BOX 315, NEW ALBANY, OH 43054-0315
(409) 750-2576
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WV25265
STATE LICENSE
WV
Enumeration date
03/23/2021
Last updated
05/02/2021
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