Provider Demographics
NPI:1700224714
Name:DR. ROBERT H SHARP, PC
Entity Type:Organization
Organization Name:DR. ROBERT H SHARP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:712-243-1965
Mailing Address - Street 1:102 N FILLMORE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT AYR
Mailing Address - State:IA
Mailing Address - Zip Code:50854-1626
Mailing Address - Country:US
Mailing Address - Phone:641-464-2813
Mailing Address - Fax:
Practice Address - Street 1:102 N FILLMORE ST
Practice Address - Street 2:
Practice Address - City:MOUNT AYR
Practice Address - State:IA
Practice Address - Zip Code:50854-1626
Practice Address - Country:US
Practice Address - Phone:641-464-2813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002595152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty