Organization
NATIONAL OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL KEITH MARTIN LDO (MANAGER)
(540) 776-2933
Entity
Organization
Contact information
Practice address
4135 FRANKLIN RD, ROANOKE, VA 24018-5703
(540) 776-2933
(540) 776-2932
Mailing address
4135 FRANKLIN RD, ROANOKE, VA 24018-5703
(540) 776-2933
(540) 776-2932
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1434
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009280529
—
VA
01
—
05098
SPECTERA
VA
01
—
079880
ANTHEM
VA
01
—
5678
DAVIS VISION
VA
01
—
VA1425
EYE MED
VA
Enumeration date
06/06/2008
Last updated
06/06/2008
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