Provider Demographics
NPI:1043280399
Name:DR. ROBERT H SHARP, PC
Entity Type:Organization
Organization Name:DR. ROBERT H SHARP, PC
Other - Org Name:FAMILY VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMSEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:641-782-2111
Mailing Address - Street 1:PO BOX 323
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801-0323
Mailing Address - Country:US
Mailing Address - Phone:641-782-2111
Mailing Address - Fax:641-782-2113
Practice Address - Street 1:807 N SUMNER AVE
Practice Address - Street 2:
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-1350
Practice Address - Country:US
Practice Address - Phone:641-782-2111
Practice Address - Fax:641-782-2113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0446369Medicaid
IAI9165Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
IA0252060003Medicare NSC