Individual
DR. SHAD L WHEATLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
843 W STUART DR APT 7, HILLSVILLE, VA 24343-1555
(276) 728-9323
(276) 728-0400
Mailing address
843 W STUART DR APT 7, HILLSVILLE, VA 24343-1555
(276) 728-9323
(276) 728-0400
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001276
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821077686
—
VA
Enumeration date
01/11/2006
Last updated
11/21/2012
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