MEDICARE: DR. ROBERT CRAIG WHEATALL O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WC0802X	Corneal and Contact Management Optometrist	OEG000386	PA
2	152W00000X	Optometrist	OEG000386	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	0146830001	OTHER	PA	MEDICARE DME
4	410024918	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	425817	OTHER	PA	HIGHMARK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003811126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT CRAIG WHEATALL O.D.

Provider Business Mailing Address
First Line	:	391 EVANS CITY RD
Second Line	:
City	:	BUTLER
State	:	PA
Zip	:	16001-6737
Country	:	US
Telephone Number	:	724-283-8144
Fax Number	:	724-283-7303

Provider Business Practice Location Address
First Line	:	391 EVANS CITY RD
Second Line	:
City	:	BUTLER
State	:	PA
Zip	:	16001-6737
Country	:	US
Telephone Number	:	724-283-7303
Fax Number	:	724-283-8144

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	02/10/2025

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