Organization
EYE PHYSICIANS OF SOUTHWEST VIRGINIA P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN TRENT (ADMINISTRATOR)
(276) 628-3118
Entity
Organization
Contact information
Practice address
340 W MAIN ST, ABINGDON, VA 24210-2624
(276) 628-3118
(276) 628-8342
Mailing address
340 W MAIN ST, ABINGDON, VA 24210-2624
(276) 628-3118
(276) 628-8342
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CM6002
RAILROAD MEDICARE
VA
Enumeration date
09/08/2005
Last updated
03/28/2023
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