Provider Demographics
NPI:1356304364
Name:BURR, MATTHEW LLOYD (OD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:LLOYD
Last Name:BURR
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 1:27 JOSEPH DR
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:17007-9549
Mailing Address - Country:US
Mailing Address - Phone:717-218-4517
Mailing Address - Fax:
Practice Address - Street 1:5295 E TRINDLE RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-3565
Practice Address - Country:US
Practice Address - Phone:717-697-9442
Practice Address - Fax:717-697-9438
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000026152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1356304364OtherNPI
531158OtherARBO OE TRACKER
PA397111OtherNATIONAL VISION ADMIN.
PABU274270OtherCLARITY VISION