Provider Demographics
NPI:1316172893
Name:KARL C. SALIBA, O.D., PC
Entity type:Organization
Organization Name:KARL C. SALIBA, O.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:C
Authorized Official - Last Name:SALIBA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:540-774-8007
Mailing Address - Street 1:595 FLOYD HWY N
Mailing Address - Street 2:
Mailing Address - City:FLOYD
Mailing Address - State:VA
Mailing Address - Zip Code:24091-2636
Mailing Address - Country:US
Mailing Address - Phone:540-745-3100
Mailing Address - Fax:
Practice Address - Street 1:595 FLOYD HWY N
Practice Address - Street 2:
Practice Address - City:FLOYD
Practice Address - State:VA
Practice Address - Zip Code:24091-2636
Practice Address - Country:US
Practice Address - Phone:540-745-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-27
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6213570001Medicare NSC