Stanley Horton Botts Jr., O.D.
Individual provider Active NPI Optometrist · Norton, VA
NPI 1306040910 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1306040910
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 0618000017 (VA)
- Practice address
- 780 Commonwealth Dr
Optometrist Suite
Norton, VA 24273-4051 - Phone
- (276) 870-7712
- NPI assigned
- Jun 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0618000017 | VA | Yes |
Addresses
Primary practice location
780 Commonwealth Dr
Optometrist Suite
Norton, VA 24273-4051
Mailing address
122 Wyandotte Ave E
Big Stone Gap, VA 24219-2934
Phone (276) 523-2319
Other providers in Norton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.