Organization
ROBERT C. WHEATALL, OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT C WHEATALL OD (OWNER)
(724) 287-1771
Entity
Organization
Contact information
Practice address
116 EVANS RD, BUTLER, PA 16001-1970
(724) 287-1771
(724) 287-6572
Mailing address
116 EVANS RD, BUTLER, PA 16001-1970
(724) 287-1771
(724) 287-6572
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000386
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001329946
HIGHMARK BLUE SHIELD
PA
05
—
1009472500001
—
PA
01
—
CH8979
RAILROAD MEDICARE
—
Enumeration date
07/18/2006
Last updated
08/30/2010
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