Organization
DAVID A GLADWELL OD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA PORTER MAYHEW (SECRETARY RECEPTIONIST)
(540) 586-9575
Entity
Organization
Contact information
Practice address
412 N BRIDGE ST, BEDFORD, VA 24523-0238
(540) 586-9575
(540) 586-0129
Mailing address
412 N BRIDGE ST, BEDFORD, VA 24523-0238
(540) 586-9575
(540) 586-0129
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0601000565
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0497490001
ADMINASTAR FEDERAL DMERC
—
01
—
066991
ANTHEM BCBS
—
Enumeration date
04/05/2006
Last updated
03/06/2008
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