Provider Demographics
NPI:1487617874
Name:ARMSTRONG, DAVID L (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 BRAMBLETON AVE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-6519
Mailing Address - Country:US
Mailing Address - Phone:540-982-2020
Mailing Address - Fax:540-982-0050
Practice Address - Street 1:3407 BRAMBLETON AVE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-6519
Practice Address - Country:US
Practice Address - Phone:540-982-2020
Practice Address - Fax:540-982-0050
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000680152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA92-0304-4Medicaid
VA410000387Medicare ID - Type Unspecified
VA92-0304-4Medicaid