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4001 College Ave, Bluefield, VA 24605-2043 | |
(276) 322-2347 | |
(276) 322-4812 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 4001 College Ave, Bluefield, Virginia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1932629052 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | 0618001786 (Virginia) | Primary |
Provider Name | Robert A Wade |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1922242403 PECOS PAC ID: 3274688502 Enrollment ID: I20121109000456 |
Mailing Address | Practice Location Address |
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4001 College Ave, Bluefield, VA 24605-2043 Ph: (276) 322-2347 | 4001 College Ave, Bluefield, VA 24605-2043 Ph: (276) 322-2347 |