Provider Demographics
NPI:1336117118
Name:DR. ROBERT H. SHARP, P.C.
Entity Type:Organization
Organization Name:DR. ROBERT H. SHARP, P.C.
Other - Org Name:DBA FAMILY VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:712-243-1965
Mailing Address - Street 1:715 DAVIS AVE
Mailing Address - Street 2:PO BOX 306
Mailing Address - City:CORNING
Mailing Address - State:IA
Mailing Address - Zip Code:50841-1418
Mailing Address - Country:US
Mailing Address - Phone:641-322-3147
Mailing Address - Fax:641-322-3853
Practice Address - Street 1:715 DAVIS AVE
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:IA
Practice Address - Zip Code:50841-1418
Practice Address - Country:US
Practice Address - Phone:641-322-3147
Practice Address - Fax:641-322-3853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-09
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0739615Medicaid
IA0252060002Medicare NSC
IAI9161Medicare PIN