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NPI Code Detail

MEDICARE: DR. JOHN ROBERT SCIBAL O.D.

MEDICARE: DR. JOHN ROBERT SCIBAL 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
1152W00000XOptometrist1125NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780707984
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN ROBERT SCIBAL O.D.
Provider Business Mailing Address
First Line : 1102 SHEPARD ST
Second Line :
City : MOREHEAD CITY
State : NC
Zip : 28557-4155
Country : US
Telephone Number : 252-349-4051
Fax Number :
Provider Business Practice Location Address
First Line : 570 PAMLICO PLZ
Second Line :
City : WASHINGTON
State : NC
Zip : 27889-3337
Country : US
Telephone Number : 252-948-2680
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 05/27/2022

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