Provider Demographics
NPI:1861426660
Name:PHIBBS, CURTIS PAUL (OD, MS)
Entity type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:PAUL
Last Name:PHIBBS
Suffix:
Gender:M
Credentials:OD, MS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:61 WINDY LN
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:PA
Mailing Address - Zip Code:17752-8782
Mailing Address - Country:US
Mailing Address - Phone:570-515-0083
Mailing Address - Fax:570-326-2880
Practice Address - Street 1:567 E 3RD ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-5316
Practice Address - Country:US
Practice Address - Phone:570-323-8000
Practice Address - Fax:570-326-2880
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE-007061-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU01435Medicare UPIN
PAU01435Medicare UPIN