Provider Demographics
NPI:1144313933
Name:SWATTS, LEAH RAMOS (OD)
Entity type:Individual
Prefix:DR
First Name:LEAH
Middle Name:RAMOS
Last Name:SWATTS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:LEAH
Other - Middle Name:MARANAN
Other - Last Name:RAMOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:1249 CEDAR RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-7292
Mailing Address - Country:US
Mailing Address - Phone:757-436-3937
Mailing Address - Fax:757-436-3209
Practice Address - Street 1:1249 CEDAR RD
Practice Address - Street 2:SUITE 104
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-7292
Practice Address - Country:US
Practice Address - Phone:757-436-3937
Practice Address - Fax:757-436-3209
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001175152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA54-2057458OtherVISION SERVICE PLAN
VA6533350OtherCIGNA
VA7387447OtherAETNA
VA009999680Medicaid
VA54-2057485OtherTRICARE
VA42756OtherDAVIS VISION
VARA1495215OtherCLARITY
VA466013OtherANTHEM
VA54-2057458OtherVISION SERVICE PLAN
VA466013OtherANTHEM