Provider Demographics
NPI:1437403177
Name:NATALIE J. NOBLE, O.D. VISION CENTER, LLC
Entity Type:Organization
Organization Name:NATALIE J. NOBLE, O.D. VISION CENTER, LLC
Other - Org Name:NOBLE VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:NOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-837-1240
Mailing Address - Street 1:124 S PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-3005
Mailing Address - Country:US
Mailing Address - Phone:724-837-1240
Mailing Address - Fax:
Practice Address - Street 1:124 S PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-3005
Practice Address - Country:US
Practice Address - Phone:724-837-1240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-02
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002377152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
001617760OtherBLUE CROSS
5620390OtherCIGNA
201215OtherUPMC
081271OtherMEDICARE PTAN
192705SYEOtherMEDICARE PROVIDER
3501749OtherAETNA
102563420OtherWELFARE/MEDICAL ASSISTANCE
2574574OtherHIGHMARK
PA78769OtherVBA