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MARY WASHINGTON EYE CARE CENTER LLC NPI 1720301625


NPI Information

NPI: 1720301625
Provider Name: MARY WASHINGTON EYE CARE CENTER, LLC
Classification: Ophthalmology - 207W00000X
Entity Type: Organization

CLIA Number: 49D2117457

Address:
4710 SPOTSYLVANIA PKWY
FREDERICKSBURG, VA
ZIP 22407
Phone: (540) 741-2733
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MARY WASHINGTON EYE CARE CENTER, LLC is an ophthalmology in Fredericksburg, VA. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. MARY WASHINGTON EYE CARE CENTER, LLC NPI is 1720301625. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4710 SPOTSYLVANIA PKWY
FREDERICKSBURG, VA
ZIP 22407-433
Phone: (540) 741-2733

The provider's authorized official is Michael P Mcdermott .
The authorized official title is Chief Executive Officer and has the following contact phone number (540) 741-1414.

The CLIA number assigned to this NPI record is 49D2117457 - other - eye center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/5/2010 and was last updated on 9/24/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometristNo
2207W00000XOphthalmologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1C11070MEDICARE OSCAR/CERTIFICATIONVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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