Individual
DR. KENNETH A LEBOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D., F.A.A.O.
Contact information
Practice address
345 EDWIN DR, VIRGINIA BEACH, VA 23462-4522
(757) 497-5555
(757) 499-2636
Mailing address
345 EDWIN DR, VIRGINIA BEACH, VA 23462-4522
(757) 497-5555
(757) 499-2636
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
0618000344
VA
152WC0802X
Corneal and Contact Management Optometrist
0618001847
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006473
BLUE CROSS BLUE SHIELD
VA
01
—
VA0000456
TRICARE/CHAMPUS
VA
Enumeration date
09/20/2005
Last updated
09/07/2023
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