Organization
JAMES RIVER EYE PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACY L REYNOLDS (INSURANCE REPRESENTATIVE)
(757) 595-8404
Entity
Organization
Contact information
Practice address
704 THIMBLE SHOALS BLVD, SUITE 100, NEWPORT NEWS, VA 23606-4544
(757) 595-8404
(757) 595-8353
Mailing address
704 THIMBLE SHOALS BLVD, SUITE 100, NEWPORT NEWS, VA 23606-4544
(757) 595-8404
(757) 595-8353
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0618000430
VA
152W00000X
Optometrist
0618001144
VA
152W00000X
Optometrist
0618001735
VA
207W00000X
Ophthalmology Physician
Primary
0101041607
VA
207W00000X
Ophthalmology Physician
0101056628
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006305547
—
VA
01
—
324304
ANTHEM BCBS
—
Enumeration date
04/06/2010
Last updated
04/06/2010
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