Healthcare Provider Details

I. General information

NPI: 1437269958
Provider Name (Legal Business Name): GETTYSBURG OPHTHALMOLOGY ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 11/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 S WASHINGTON ST SUITE 24
GETTYSBURG PA
17325-2516
US

IV. Provider business mailing address

455 S WASHINGTON ST SUITE 24
GETTYSBURG PA
17325-2516
US

V. Phone/Fax

Practice location:
  • Phone: 717-334-9159
  • Fax: 717-334-7225
Mailing address:
  • Phone: 717-334-9159
  • Fax: 717-334-7225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. DUANE M WHITLOCK
Title or Position: PRESIDENT/OPHTHALMOLOGIST
Credential: M.D.
Phone: 717-334-9159