Dr. Russell Hale Mattern
Optometrist
2700 Potomac Mills Cir Suite 207
Woodbridge
, Virginia 22192-4625
Dr. Russell Hale Mattern
Optometrist
2700 Potomac Mills Cir Suite 207
Woodbridge
, Virginia 22192-4625
(703) 490-5275
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Dr. Russell Hale Mattern
- 2700 Potomac Mills Cir Suite 207
- Woodbridge, VA
- Zip : 22192-4625
- Phone : (703) 490-5275
Second Address
- Dr. Russell Hale Mattern
- 2700 Potomac Mills Cir Suite 207
- Woodbridge, VA
- Zip : 22192-4625
- Phone : (703) 490-5275
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 0601000964 | VA |
National Provider Identifier
| NPI | 1003134248 |
|---|---|
| Provider Name | Dr. Russell Hale Mattern |
| First Address | Woodbridge, VA 22192-4625 |
| Second Address | Woodbridge, VA 22192-4625 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/05/2010 |
| Last Update Date | 12/05/2010 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.