| Bradley W Church, OD | |
|
15189 Montanus Dr, Culpeper, VA 22701-1679 | |
| (540) 825-8220 | |
| (866) 691-2912 |
| Full Name | Bradley W Church |
|---|---|
| Gender | Male |
| Speciality | Optometry |
| Experience | 28 Years |
| Location | 15189 Montanus Dr, Culpeper, Virginia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790762821 | NPI | - | NPPES |
| 410036701 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 0618000722 (Virginia) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Aeg Virginia Professional Pllc | 1456898782 | 3 |
| Provider Name | Premier Eyecare, Angela Tsai, O.d. And Associates, P.c. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1134137086 PECOS PAC ID: 6305846718 Enrollment ID: O20070216000245 |
| Provider Name | Aeg Virginia Professional Pllc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1518746908 PECOS PAC ID: 1456898782 Enrollment ID: O20240805003293 |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley W Church, OD 15189 Montanus Dr, Culpeper, VA 22701-1679 Ph: (540) 825-8220 | Bradley W Church, OD 15189 Montanus Dr, Culpeper, VA 22701-1679 Ph: (540) 825-8220 |
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