Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OE004419T | PA |
NPI | 1013033067 |
---|---|
Provider Name | Dr. Robert Eli Brown |
First Address | Kingston, PA 18704-5215 |
Second Address | Kingston, PA 18704-3422 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 29/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
17290 | GEISINGER HEALTH PLAN (01) | PA |
284812 | BLUE CROSS BLUE SHIELD (01) | PA |
397424 | NVA (01) | PA |
42844 | SPECTERA (01) | PA |
5107010 | AETNA (01) | PA |
51425 | DAVIS VISION (01) | PA |
816929 | FIRST PRIORITY HEALTH (01) | PA |
PA693 | VBA (01) | PA |