Dr. Robert G. Mahoney
Optometrist
4304 Taylor Ave
Racine
, Wisconsin 53405-4641
Dr. Robert G. Mahoney
Optometrist
4304 Taylor Ave
Racine
, Wisconsin 53405-4641
(262) 404-5001
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Dr. Robert G. Mahoney
- 4304 Taylor Ave
- Racine, WI
- Zip : 53405-4641
- Phone : (262) 404-5001
Second Address
- Dr. Robert G. Mahoney
- 4304 Taylor Ave
- Racine, WI
- Zip : 53405-4641
- Phone : (262) 404-5001
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2190-035 | WI |
National Provider Identifier
| NPI | 1003904483 |
|---|---|
| Provider Name | Dr. Robert G. Mahoney |
| First Address | Racine, WI 53405-4641 |
| Second Address | Racine, WI 53405-4641 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/10/2006 |
| Last Update Date | 03/05/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 207481 | EYEMED VISION NO. (01) | |
| 38532000 | (05) | WI |
| T62668 | (02) | WI |
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.