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NPI Code Detail

MEDICARE: A STEPHEN PEYTON JR.

MEDICARE: A STEPHEN PEYTON JR.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOEG000144PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12487437OTHERPAAETNA
2410049709OTHERPAPALMETTO GBA
34754342002OTHERPACIGNA
402768500OTHERPACAPITAL BLUE CROSS
5PE529728OTHERPAHIGHMARK

General Provider Information

NPI Number : 1326148255
Entity Type Code : Organization
Provider Name (Legal Business Name) : A STEPHEN PEYTON JR.
Provider Business Mailing Address
First Line : 180 GOOD DR
Second Line : SUITE 2
City : LANCASTER
State : PA
Zip : 17603-2353
Country : US
Telephone Number : 717-397-2020
Fax Number : 717-399-0220
Provider Business Practice Location Address
First Line : 180 GOOD DR
Second Line : SUITE 2
City : LANCASTER
State : PA
Zip : 17603-2353
Country : US
Telephone Number : 717-397-2020
Fax Number : 717-399-0220
Authorized Official
Title or Position : PROPRIETOR
Name : ANDREW STEPHEN PEYTON JR.
Credential : O.D.
Telephone Number : 717-397-2020
Provider Enumeration Date : 09/22/2006
Last Update Date : 02/06/2015

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