Organization
CHARLOTTESVILLE EYE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A. GONCE MD (SECRETARY)
(434) 977-5160
Entity
Organization
Contact information
Practice address
110 S PANTOPS DR, CHARLOTTESVILLE, VA 22911-8672
(434) 977-6697
(434) 977-6714
Mailing address
110 S PANTOPS DR, CHARLOTTESVILLE, VA 22911-8672
(434) 977-6697
(434) 977-6714
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0756400001
DMERC
VA
Enumeration date
07/21/2005
Last updated
02/14/2008
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