Provider Demographics
NPI:1821096991
Name:COLON, ROBERT A (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:COLON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2209 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-2458
Mailing Address - Country:US
Mailing Address - Phone:775-738-8491
Mailing Address - Fax:775-738-3313
Practice Address - Street 1:2209 N 5TH ST
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-2458
Practice Address - Country:US
Practice Address - Phone:775-738-8491
Practice Address - Fax:775-738-3313
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV149152W00000X, 152WL0500X, 152WP0200X, 152WS0006X, 152WX0102X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV410021227OtherRR MEDICARE
NV627631OtherBCBS MEDIGAP
NV0373120001OtherDMERC PIN
NV00010029440OtherTAT
NVWCHMJOtherGROUP MEDICARE PIN
NV002504520Medicaid