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General NPI Number Information
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NPI Number | 1265548531
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Entity Type | Individual
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Provider Name | BENJAMIN HAROLD WHITLING O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 04/14/2011
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Provider Practice Location Address
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Address Line | 21920 ROUTE 119
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City | PUNXSUTAWNEY
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State | PA
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Zip | 15767-7975
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Country | US
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Telephone | 814-938-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 447 JARED ST
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City | BROOKVILLE
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State | PA
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Zip | 15825-1190
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OEG001813
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License Number State | PA
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