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NPI Code Detail

MEDICARE: DR. ROBERT C WEIXELDORFER OD

MEDICARE: DR. ROBERT C WEIXELDORFER OD
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
1152W00000XOptometrist1635KS
2152W00000XOptometrist2001023319MO

General Provider Information

NPI Number : 1528051802
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT C WEIXELDORFER OD
Provider Business Mailing Address
First Line : 4801 S CLIFF AVE
Second Line : SUITE 100
City : INDEPENDENCE
State : MO
Zip : 64055-7015
Country : US
Telephone Number : 816-478-1230
Fax Number : 816-478-4413
Provider Business Practice Location Address
First Line : 600 NW MURRAY RD
Second Line : STE 115
City : LEES SUMMIT
State : MO
Zip : 64081-1204
Country : US
Telephone Number : 816-478-1230
Fax Number : 816-350-4190
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2005
Last Update Date : 12/06/2007

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Directions to “ DR. ROBERT C WEIXELDORFER OD” Practice Location

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