Provider Demographics
NPI:1043411176
Name:MACALPINE, ROBERT (OD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:MACALPINE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1279
Mailing Address - Country:US
Mailing Address - Phone:781-331-4004
Mailing Address - Fax:781-331-5004
Practice Address - Street 1:1690 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1279
Practice Address - Country:US
Practice Address - Phone:781-331-4004
Practice Address - Fax:781-331-5004
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4150152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0317748Medicaid
MAU91208Medicare UPIN
MAW1743101Medicare PIN