Provider Demographics
NPI:1376726307
Name:ROBBINS & ZIRKLE, PTRS.
Entity Type:Organization
Organization Name:ROBBINS & ZIRKLE, PTRS.
Other - Org Name:ROBBINS & ZIRKLE, PROGRESSIVE OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:ZIRKLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:765-674-7525
Mailing Address - Street 1:610 W 38TH ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46953-4864
Mailing Address - Country:US
Mailing Address - Phone:765-674-7525
Mailing Address - Fax:765-674-7844
Practice Address - Street 1:610 W 38TH ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-4864
Practice Address - Country:US
Practice Address - Phone:765-674-7525
Practice Address - Fax:765-674-7844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-13
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN296560Medicare PIN
IN3995910001Medicare NSC