1932278256 NPI number — NATHAN C. STEBBINS, O.D.,P.C.

Table of content: (NPI 1932278256)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932278256 NPI number — NATHAN C. STEBBINS, O.D.,P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATHAN C. STEBBINS, O.D.,P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932278256
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 S FINDLEY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PUNXSUTAWNEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15767-2048
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-938-5920
Provider Business Mailing Address Fax Number:
814-938-6926

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 S FINDLEY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PUNXSUTAWNEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15767-2048
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-938-5920
Provider Business Practice Location Address Fax Number:
814-938-6926
Provider Enumeration Date:
11/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
STEBBINS
Authorized Official First Name:
NATHAN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
814-938-5920

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OEG01190 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: OEG001190PA . This is a "VBA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 27773 . This is a "SPECTERA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1009134120001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50430 . This is a "DAVIS VISION" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: ST1533880 . This is a "OPTIVISION" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 397487 . This is a "NVA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50430 . This is a "UNISON" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: P00056674 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50430 . This is a "MED PLUS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: M1360 . This is a "SAUFLON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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