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Organization

RICHARD E SHEAFFER & PHILLIP L WISE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD EDGAR SHEAFFER O.D. (PARTNER)
(570) 374-8136
Entity
Organization

Contact information

Practice address
326 BROAD ST, SELINSGROVE, PA 17870-1512
(570) 374-8136
(570) 374-0462
Mailing address
326 BROAD ST, SELINSGROVE, PA 17870-1512
(570) 374-8136
(570) 374-0462

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001244
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0012999300005
PA
01
12549200
CAPITAL BLUE CROSS
PA
01
1592
GEISINGER HEALTH PLAN
PA
Enumeration date
03/20/2006
Last updated
01/27/2010
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