Individual
DR. TOD R DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
10687 GASKINS WAY, SUITE 201, MANASSAS, VA 20109
(703) 753-9777
(703) 753-9077
Mailing address
10687 GASKINS WAY, SUITE 201, MANASSAS, VA 20109
(703) 753-9777
(703) 753-9077
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0601002358
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009230831
—
VA
01
—
317179
ANTHEM PROVIDER ID
VA
Enumeration date
07/27/2006
Last updated
02/26/2025
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