Individual
SCOTT THOMAS NILSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2000 GENERAL BOOTH BLVD, VIRGINIA BEACH, VA 23454-5876
(575) 426-2020
Mailing address
2000 GENERAL BOOTH BLVD, VIRGINIA BEACH, VA 23454-5876
(575) 426-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001752
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427498344
GROUP NPI
VA
Enumeration date
06/18/2008
Last updated
03/17/2015
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