Provider Demographics
NPI:1871615542
Name:DILZER EYE CARE ASSOCIATES, P.C.
Entity type:Organization
Organization Name:DILZER EYE CARE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF OPTOMETRY
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:DILZER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:540-338-1833
Mailing Address - Street 1:530 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-3171
Mailing Address - Country:US
Mailing Address - Phone:540-338-1833
Mailing Address - Fax:540-338-3791
Practice Address - Street 1:530 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-3171
Practice Address - Country:US
Practice Address - Phone:540-338-1833
Practice Address - Fax:540-338-3791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000662152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA223707OtherANTHEM BLUE CROSS AND BLUE SHIELD PROVIDER ID
VAC05683OtherMEDICARE GROUP #
VA223707OtherANTHEM BLUE CROSS AND BLUE SHIELD PROVIDER ID
VA1223450001Medicare NSC
VAU68453Medicare UPIN