Provider Demographics
NPI:1952362451
Name:PAPE, ROBYN ANN (OD)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:ANN
Last Name:PAPE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:443 GENERAL HARTINGER PKWY
Mailing Address - Street 2:
Mailing Address - City:MIDDLEPORT
Mailing Address - State:OH
Mailing Address - Zip Code:45760-1251
Mailing Address - Country:US
Mailing Address - Phone:740-691-5008
Mailing Address - Fax:740-691-5009
Practice Address - Street 1:443 GENERAL HARTINGER PKWY
Practice Address - Street 2:
Practice Address - City:MIDDLEPORT
Practice Address - State:OH
Practice Address - Zip Code:45760-1251
Practice Address - Country:US
Practice Address - Phone:740-691-5008
Practice Address - Fax:740-691-5009
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5076T1953152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2149679Medicaid
U84489Medicare UPIN
OHSA4046112Medicare ID - Type Unspecified