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Organization

ALBEMARLE PEDIATRIC OPHTHALMOLOGY & STRABISMUS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. GALE KINNIER MARTIN (OFFICE ADMINISTRATOR)
(434) 295-5193
Entity
Organization

Contact information

Practice address
1101 EAST JEFFERSON STREET, SUITE 3, CHARLOTTESVILLE, VA 22902-5353
(434) 295-5193
(434) 977-0714
Mailing address
1101 EAST JEFFERSON STREET, SUITE 3, CHARLOTTESVILLE, VA 22902-5353
(434) 295-5193
(434) 977-0714

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101239819
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003205
ANTHEM BCBS
VA
05
006370551
VA
05
010299349
VA
01
1477555399
INDIVIDUAL NPI #
01
1972510113
INDIVIDUAL NPI #
01
400262000
SOUTHERN HEALTH
VA
01
435561
SOUTHERN HEALTH
VA
Enumeration date
11/22/2006
Last updated
04/26/2010
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