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Individual

WILLIAM R WALDRON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000144
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009235281
VA
01
10997
AVESIS
VA
01
2149623
AETNA U.S. HEALTHCARE
VA
01
320-621
MAMSI
VA
01
381285
ANTHEM BLUE CROSS
VA
01
56056
SENTARA
VA
01
WA917852
CLARITY VISION
VA
Enumeration date
06/23/2005
Last updated
03/09/2010
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