MEDICARE: ROBERT H. QUICK O.D.

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
1	152W00000X	Optometrist	299	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346213154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT H. QUICK O.D.

Provider Business Mailing Address
First Line	:	PO BOX 1640
Second Line	:
City	:	CEDAR CREST
State	:	NM
Zip	:	87008-1640
Country	:	US
Telephone Number	:	505-286-0300
Fax Number	:	505-286-7754

Provider Business Practice Location Address
First Line	:	12220 HWY 14 N
Second Line	:	SUITE 3
City	:	CEDAR CREST
State	:	NM
Zip	:	87008-9407
Country	:	US
Telephone Number	:	505-286-0300
Fax Number	:	505-286-7754

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	12/28/2012

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