Provider Demographics
NPI:1871599068
Name:OWENS, ROBERT L II (OD, FAAO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:OWENS
Suffix:II
Gender:M
Credentials:OD, FAAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:654 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17557-1410
Mailing Address - Country:US
Mailing Address - Phone:717-354-2251
Mailing Address - Fax:717-355-2138
Practice Address - Street 1:654 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW HOLLAND
Practice Address - State:PA
Practice Address - Zip Code:17557-1410
Practice Address - Country:US
Practice Address - Phone:717-354-2251
Practice Address - Fax:717-355-2138
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2010-05-04
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-06-27
Provider Licenses
StateLicense IDTaxonomies
PAOEG001333152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT29979Medicare UPIN
PA182408P4FMedicare PIN