Olivia Novak, OD | |
2015 Waterside Rd, Prince George, VA 23875-1265 | |
(804) 733-7300 | |
(804) 733-7390 |
Full Name | Olivia Novak |
---|---|
Gender | Female |
Speciality | Optometrist |
Location | 2015 Waterside Rd, Prince George, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1962243469 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 0618003463 (Virginia) | Primary |
152W00000X | Optometrist | OPT.007299 (Ohio) | Secondary |
Provider Name | Optometric Management Group Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1265534093 PECOS PAC ID: 7517034291 Enrollment ID: O20080922000553 |
Mailing Address | Practice Location Address |
---|---|
Olivia Novak, OD 2015 Waterside Rd, Prince George, VA 23875-1265 Ph: (804) 733-7300 | Olivia Novak, OD 2015 Waterside Rd, Prince George, VA 23875-1265 Ph: (804) 733-7300 |
Dr. Justin Autry, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2015 Waterside Rd, Prince George, VA 23875 Phone: 804-733-7300 Fax: 804-733-7387 | |
Kulsoom T. Murtaza, OD Optometrist Medicare: Medicare Enrolled Practice Location: 2015 Waterside Rd, Prince George, VA 23875 Phone: 804-733-7300 Fax: 804-733-7390 | |
Thomas Matlock Wyman, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2015 Waterside Rd, Prince George, VA 23875 Phone: 804-287-4200 |