Organization
VIRGINIA OPTICAL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS POWELL FISHER JR. OPTICIAN (OPTICIAN OWNER)
(804) 861-3005
Entity
Organization
Contact information
Practice address
1980 S SYCAMORE ST, PETERSBURG, VA 23805-2729
(804) 861-3005
(804) 861-8243
Mailing address
1980 S SYCAMORE ST, PETERSBURG, VA 23805-2729
(804) 861-3005
(804) 861-8243
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1101001155
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009282572
—
VA
01
—
061380
ANTHEM
VA
01
—
VA1155
EYE MED VISION CARE
VA
Enumeration date
09/22/2006
Last updated
05/16/2016
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