Provider Demographics
NPI:1376644476
Name:SHULER, ROBERT KEITH JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:KEITH
Last Name:SHULER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:320 PROSPERITY DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4709
Mailing Address - Country:US
Mailing Address - Phone:423-756-1512
Mailing Address - Fax:
Practice Address - Street 1:1124 E WEISGARBER RD
Practice Address - Street 2:SUITE 207
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2686
Practice Address - Country:US
Practice Address - Phone:865-588-0811
Practice Address - Fax:865-584-2153
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN48338207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1376644476Medicaid
SCQ0062GMedicaid
NCFH2967455OtherFIRSTCAROLINACARE
TNP01075886OtherRAILROAD MEDICARE
NC1390HOtherBCBS OF NC
NCP00424684OtherRAILROAD MEDICARE
TN1527449Medicaid
NC5901600Medicaid
TN1527449Medicaid
VA1376644476Medicaid
NC2044488AMedicare PIN
NCI38235Medicare UPIN
TN103I189886Medicare PIN