Provider Demographics
NPI:1982629101
Name:BIDDLE, ROBERT EUGENE JR (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EUGENE
Last Name:BIDDLE
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-2808
Mailing Address - Country:US
Mailing Address - Phone:724-929-6100
Mailing Address - Fax:724-929-7489
Practice Address - Street 1:830 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012-2808
Practice Address - Country:US
Practice Address - Phone:724-929-6100
Practice Address - Fax:724-929-7489
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-002142-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT27189Medicare UPIN
PA19870550Medicaid
PA031846KTZMedicare ID - Type Unspecified