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General NPI Number Information
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NPI Number | 1962578823
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Entity Type | Organization
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Legal Business Name | ROBERT E TITCOMB OFFICE
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Dates
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Enumeration Date | 11/24/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 217 MASON AVE
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City | CAPE CHARLES
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State | VA
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Zip | 23310-3201
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Country | US
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Telephone | 757-331-2020
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Fax | 757-331-4077
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Provider Business Mailing Address
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Address Line | 217 MASON AVE
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City | CAPE CHARLES
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State | VA
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Zip | 23310-3201
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Country | US
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Telephone | 757-331-2020
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Fax | 757-331-4077
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Authorized Official
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Title or Position | OPTOMETRIST OWNER
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Name | DR. ROBERT EDWARD TITCOMB
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Credential | OD
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Telephone | 757-331-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 0618000523
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | 0618000523
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618000523
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License Number State | VA
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