Provider Demographics
NPI:1841236023
Name:TOLER, ROBERT L (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:TOLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 PERRY RD
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-7702
Mailing Address - Country:US
Mailing Address - Phone:919-362-1962
Mailing Address - Fax:919-589-9899
Practice Address - Street 1:821 PERRY RD
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-7702
Practice Address - Country:US
Practice Address - Phone:919-362-1962
Practice Address - Fax:919-589-9899
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1093152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8909904Medicaid
NC2254062OtherUNITED
NC09904OtherBCBS
NC8909904Medicaid
NC09904OtherBCBS
NC246454DMedicare ID - Type Unspecified