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General NPI Number Information
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NPI Number | 1659372696
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Entity Type | Individual
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Provider Name | ROBERT B AUSTIN O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/01/2005
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 27 MAIN ST
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City | VERGENNES
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State | VT
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Zip | 05491-1113
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Country | US
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Telephone | 802-877-2422
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Fax | 802-877-1124
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Provider Business Mailing Address
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Address Line | P.O. BOX 174 27 MAIN ST
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City | VERGENNES
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State | VT
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Zip | 05491-0174
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Country | US
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Telephone | 802-877-2422
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Fax | 802-877-1124
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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 | 0300000292
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 56-005641
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License Number State | NY
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