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Contact Information

W. BERRY MAULTSBY, JR., O.D., P.C.
413 MT. CROSS ROAD
SUITE 203
DANVILLE, VA24540
 Phone: 434-791-3937
 Fax: 434-791-2468
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for W. BERRY MAULTSBY, JR., O.D., P.C.

NPI # 1134354897
LBN Legal business name W. BERRY MAULTSBY, JR., O.D., P.C.
Authorized official WALLACE MAULTSBY - (OPTOMETRIST)
Entity Organization
Organization subpart 1 No
Enumeration date 05/26/2009
Last updated 06/02/2009 - About 17 years ago
Identifiers
VA License # 0618000688
VA Medicaid 010337861
Other 465270 ANTHEM
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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