Organization
WILLIAM ALAN RADA, OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM ALAN RADA O.D. (OWNER)
(304) 925-4761
Entity
Organization
Contact information
Practice address
4202 MACCORKLE AVE SE, CHARLESTON, WV 25304-2502
(304) 925-4761
(304) 925-0310
Mailing address
4202 MACCORKLE AVE SE, CHARLESTON, WV 25304-2502
(304) 925-4761
(304) 925-0310
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
774OD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410004799
RAIL ROAD MEDICARE
WV
Enumeration date
09/13/2007
Last updated
12/03/2010
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