Provider Demographics
NPI:1215152285
Name:ROBERT A. HARPER
Entity type:Organization
Organization Name:ROBERT A. HARPER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER-OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:623-584-1366
Mailing Address - Street 1:13920 W CAMINO DEL SOL
Mailing Address - Street 2:STE. 6
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-4438
Mailing Address - Country:US
Mailing Address - Phone:623-584-1366
Mailing Address - Fax:623-584-1329
Practice Address - Street 1:13920 W CAMINO DEL SOL
Practice Address - Street 2:STE. 6
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4438
Practice Address - Country:US
Practice Address - Phone:623-584-1366
Practice Address - Fax:623-584-1329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOD731152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0735290001Medicare NSC
AZZ62195Medicare PIN