Individual
DR. KENNETH W ALPHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000865
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001240520
—
PA
01
—
072343
FIRST PRIORITY HEALTH
—
01
—
20987
GEISINGER HEALTH PLAN
—
01
—
410024725
RAILROAD MEDICARE
—
01
—
506554
AETNA
—
01
—
AL513333
HIGH MARK BLUE SHIELD
—
Enumeration date
08/13/2006
Last updated
01/05/2010
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