MEDICARE: DR. ROBERT REISS SZELIGA 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	2599	TN

General Provider Information

NPI Number	:	1982778825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT REISS SZELIGA O.D.

Provider Business Mailing Address
First Line	:	5238 MAIN ST
Second Line	:
City	:	SPRING HILL
State	:	TN
Zip	:	37174-2443
Country	:	US
Telephone Number	:	931-489-1950
Fax Number	:	931-489-1953

Provider Business Practice Location Address
First Line	:	5238 MAIN ST
Second Line	:
City	:	SPRING HILL
State	:	TN
Zip	:	37174-2443
Country	:	US
Telephone Number	:	931-489-1950
Fax Number	:	931-489-1953

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	09/12/2018

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