MEDICARE: DR. ROBERT A COLON 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	149	NV
2	152WL0500X	Low Vision Rehabilitation Optometrist	149	NV
3	152WP0200X	Pediatric Optometrist	149	NV
4	152WS0006X	Sports Vision Optometrist	149	NV
5	152WX0102X	Occupational Vision Optometrist	149	NV
6	152WC0802X	Corneal and Contact Management Optometrist	149	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	410021227	OTHER	NV	RR MEDICARE
5	WCHMJ	OTHER	NV	GROUP MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	627631	OTHER	NV	BCBS MEDIGAP
3	0373120001	OTHER	NV	DMERC PIN
4	00010029440	OTHER	NV	TAT
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821096991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT A COLON O.D.

Provider Business Mailing Address
First Line	:	2209 N 5TH ST
Second Line	:
City	:	ELKO
State	:	NV
Zip	:	89801-2458
Country	:	US
Telephone Number	:	775-738-8491
Fax Number	:	775-738-3313

Provider Business Practice Location Address
First Line	:	2209 N 5TH ST
Second Line	:
City	:	ELKO
State	:	NV
Zip	:	89801-2458
Country	:	US
Telephone Number	:	775-738-8491
Fax Number	:	775-738-3313

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	04/12/2021

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Directions to “ DR. ROBERT A COLON O.D.” Practice Location

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