Provider Demographics
NPI:1750604732
Name:ROBERT A BARCLAY & ARTAMARIE S
Entity type:Organization
Organization Name:ROBERT A BARCLAY & ARTAMARIE S
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARCLAY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:814-542-2536
Mailing Address - Street 1:44 E SHIRLEY ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT UNION
Mailing Address - State:PA
Mailing Address - Zip Code:17066-1384
Mailing Address - Country:US
Mailing Address - Phone:814-542-2536
Mailing Address - Fax:814-542-2584
Practice Address - Street 1:44 E SHIRLEY ST
Practice Address - Street 2:
Practice Address - City:MOUNT UNION
Practice Address - State:PA
Practice Address - Zip Code:17066-1384
Practice Address - Country:US
Practice Address - Phone:814-542-2536
Practice Address - Fax:814-542-2584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-05
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0EG000630152W00000X
PA0EG000631152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA186072OtherMEDICARE PTAN
PA0314160003Medicare NSC