Provider Demographics
NPI:1144309956
Name:WOLF, JULIE ANNE (OD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANNE
Last Name:WOLF
Suffix:
Gender:F
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:PO BOX 305251
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00803-5251
Mailing Address - Country:US
Mailing Address - Phone:770-596-0823
Mailing Address - Fax:770-596-0823
Practice Address - Street 1:VISION CENTER
Practice Address - Street 2:NISKY SHOPPING CENTER
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00803
Practice Address - Country:US
Practice Address - Phone:340-776-2020
Practice Address - Fax:340-776-2021
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2918152W00000X
GAOPT00001493152W00000X
VI065152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA622115955CMedicaid
GAU60456Medicare UPIN