Van De Velde, Richard A
Van De Velde, Richard A is an individual health care provider with primary practice located at 3215 Shrine Rd Suite 6, Brunswick GA 31520. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Van De Velde, Richard A can be contacted via phone (912) 267-0565.Contact Information
Primary practice address
3215 Shrine Rd Suite 6
Brunswick GA 31520
Phone: (912) 267-0565
Fax: (912) 265-0545
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT001640 | Georgia |
Profile Details
| NPI number | 1396757480 |
|---|---|
| LBN Legal business name | Van De Velde, Richard A |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 13th, 2006 |
| Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396757480 | NPPES |
| Georgia | MEDICAID | 00912821A |
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