Individual
DR. RICHARD KENNETH LODWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
101 BULIFANTS BLVD STE A, WILLIAMSBURG, VA 23188-5709
(757) 564-1907
(757) 564-1913
Mailing address
101 BULIFANTS BLVD STE A, WILLIAMSBURG, VA 23188-5709
(757) 564-1907
(757) 564-1913
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001367
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010050308
—
VA
01
—
0974810001
CIGNA DMERC
VA
01
—
103481
ANTHEM
VA
01
—
410047254
RAILROAD MEDICARE
VA
01
—
76039
OPTIMA
—
Enumeration date
07/19/2006
Last updated
10/09/2008
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