Healthcare Provider Details

I. General information

NPI: 1194273656
Provider Name (Legal Business Name): WHITLING EYE CO.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2016
Last Update Date: 09/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21920 ROUTE 119
PUNXSUTAWNEY PA
15767-7975
US

IV. Provider business mailing address

400 BUTLER ST
BROOKVILLE PA
15825-1002
US

V. Phone/Fax

Practice location:
  • Phone: 814-938-9100
  • Fax: 814-938-8431
Mailing address:
  • Phone: 814-450-4066
  • Fax: 814-849-0861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. BENJAMIN HAROLD WHITLING
Title or Position: SOLE MEMBER
Credential: O.D.
Phone: 814-450-4066