Provider Demographics
NPI:1326148255
Name:A STEPHEN PEYTON JR.
Entity Type:Organization
Organization Name:A STEPHEN PEYTON JR.
Other - Org Name:OPTOMETRIC ASSOCIATES OF LANCASTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:PEYTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:717-397-2020
Mailing Address - Street 1:180 GOOD DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-2353
Mailing Address - Country:US
Mailing Address - Phone:717-397-2020
Mailing Address - Fax:717-399-0220
Practice Address - Street 1:180 GOOD DR
Practice Address - Street 2:SUITE 2
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2353
Practice Address - Country:US
Practice Address - Phone:717-397-2020
Practice Address - Fax:717-399-0220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000144152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2487437OtherAETNA
PA410049709OtherPALMETTO GBA
PA4754342002OtherCIGNA
PA02768500OtherCAPITAL BLUE CROSS
PAPE529728OtherHIGHMARK
PA2487437OtherAETNA
PA4024520001Medicare NSC