MEDICARE: DR. ROBERT J GERBERRY 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	152W00000X	Optometrist	2943 T333	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	180011156	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000126324	OTHER	OH	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4387948	OTHER	OH	AETNA
4	2200182	OTHER	OH	UNITED HEALTHCARE
5	000099146	OTHER	OH	KEYSTONE
7	341038973A	OTHER	OH	SUMMACARE

General Provider Information

NPI Number	:	1083616676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT J GERBERRY O.D.

Provider Business Mailing Address
First Line	:	10 DUTTON DR
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44502-1818
Country	:	US
Telephone Number	:	330-746-7691
Fax Number	:	330-743-8368

Provider Business Practice Location Address
First Line	:	10 DUTTON DR
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44502-1818
Country	:	US
Telephone Number	:	330-746-7691
Fax Number	:	330-743-8368

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

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	02/09/2016

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