Individual
DR. JAMES VINCENT CORNETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
226 FORT LN, PORTSMOUTH, VA 23704-2220
(757) 393-6131
(757) 393-0976
Mailing address
226 FORT LN, PORTSMOUTH, VA 23704-2220
(757) 393-6131
(757) 939-0976
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000158
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010284716
—
VA
01
—
178555
ANTHEM BCBS
VA
01
—
25072
OPTIMA
VA
Enumeration date
11/04/2005
Last updated
06/30/2009
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