Healthcare Provider Details

I. General information

NPI: 1689644601
Provider Name (Legal Business Name): ABBY LEIGH WHITING O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ABBY LEIGH CAMPBELL

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 03/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 MERCER NEW WILMINGTON RD SUITE 2
NEW WILMINGTON PA
16142-2027
US

IV. Provider business mailing address

2055 MERCER NEW WILMINGTON RD SUITE 2
NEW WILMINGTON PA
16142-2027
US

V. Phone/Fax

Practice location:
  • Phone: 724-946-2620
  • Fax: 724-946-2622
Mailing address:
  • Phone: 724-946-2620
  • Fax: 724-946-2622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG001658
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: