Burris, Robert O

Burris, Robert O is an individual health care provider with primary practice located at 800 N Clinton St Suite D, Defiance OH 43512-4610. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Burris, Robert O can be contacted via phone (419) 782-1901.

Contact Information

Primary practice address
800 N Clinton St Suite D Defiance OH 43512-4610
Fax: (419) 782-2200
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2752 Ohio

Profile Details

NPI number 1932245909
LBN Legal business name Burris, Robert O
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 29th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932245909 NPPES
Ohio MEDICAID 0342516

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