Organization
RETINA & VITREOUS CENTER PC
Active
Other names
Wagner Kapoor Institute
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN L. WAGNER M.D. (PRESIDENT)
(757) 481-4400
Entity
Organization
Contact information
Practice address
6160 KEMPSVILLE CIR STE 120B, NORFOLK, VA 23502-3933
(757) 481-4400
(757) 481-1285
Mailing address
6160 KEMPSVILLE CIR STE 250B, NORFOLK, VA 23502-3933
(757) 481-4400
(757) 481-1285
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101039260
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006396097
—
VA
Enumeration date
10/22/2006
Last updated
01/28/2025
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