Provider Demographics
NPI:1437269958
Name:GETTYSBURG OPHTHALMOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:GETTYSBURG OPHTHALMOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WHITLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-334-9159
Mailing Address - Street 1:455 S WASHINGTON ST
Mailing Address - Street 2:SUITE 24
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-2516
Mailing Address - Country:US
Mailing Address - Phone:717-334-9159
Mailing Address - Fax:717-334-7225
Practice Address - Street 1:455 S WASHINGTON ST
Practice Address - Street 2:SUITE 24
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2516
Practice Address - Country:US
Practice Address - Phone:717-334-9159
Practice Address - Fax:717-334-7225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH90255Medicare UPIN
PAB38232Medicare UPIN
PAC330355Medicare UPIN
PAU25019Medicare UPIN
PA049534FHDMedicare ID - Type UnspecifiedJAMES M. WHITE, O.D.
PA108855FHDMedicare ID - Type UnspecifiedT. SIVENDRAN, M.D.
PA071709FHDMedicare ID - Type UnspecifiedDUANE WHITLOCK, M.D.
PA136463FHDMedicare ID - Type UnspecifiedDANIEL F. BEVILACQUA, M.D