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General NPI Number Information
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NPI Number | 1255502670
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Entity Type | Organization
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Legal Business Name | DR ROBERT C FLEISCHER OD INC
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Dates
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Enumeration Date | 03/13/2008
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Last Update Date | 05/23/2008
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Provider Practice Location Address
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Address Line | 1515 EAST MARKET STREET
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City | WARREN
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State | OH
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Zip | 44483-6641
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Country | US
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Telephone | 330-394-8862
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Fax | 330-393-0197
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Provider Business Mailing Address
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Address Line | 1515 EAST MARKET STREET
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City | WARREN
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State | OH
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Zip | 44483-6641
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Country | US
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Telephone | 330-394-8862
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Fax | 330-393-0197
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Authorized Official
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Title or Position | DR ROBERT C FLEISCHER OD INC
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Name | DR. ROBERT C FLEISCHER
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Credential | OD OPTOMETRIST
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Telephone | 330-394-8862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2790
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License Number State | OH
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