Provider Demographics
NPI:1881615219
Name:HERBST, JAMES D (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:HERBST
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:10 CAPITAL DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110
Mailing Address - Country:US
Mailing Address - Phone:717-233-3937
Mailing Address - Fax:717-233-5715
Practice Address - Street 1:717 MARKET ST.
Practice Address - Street 2:SUITE 112
Practice Address - City:LEMOYNE
Practice Address - State:PA
Practice Address - Zip Code:17043
Practice Address - Country:US
Practice Address - Phone:717-703-3937
Practice Address - Fax:717-703-5715
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2013-11-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOEG000670152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU05411Medicare UPIN
618683KFLMedicare ID - Type Unspecified