Provider Demographics
NPI:1942299524
Name:HARPER, ROBERT (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:HARPER
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 1:13920 W CAMINO DEL SOL
Mailing Address - Street 2:STE. 6
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-4438
Mailing Address - Country:US
Mailing Address - Phone:623-584-1366
Mailing Address - Fax:623-584-1329
Practice Address - Street 1:13920 W CAMINO DEL SOL
Practice Address - Street 2:STE. 6
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4438
Practice Address - Country:US
Practice Address - Phone:623-584-1366
Practice Address - Fax:623-584-1329
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2007-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ731152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0735290001OtherMEDICARE DME
AZU16774Medicare UPIN
AZZ62196Medicare PIN