Mr Robert Eugene Vandiver Ii, PA is a
Physician Assistant based in Wilburton, Oklahoma. Mr Robert Eugene Vandiver Ii is licensed to practice in Oklahoma (license number 527) and his current practice location is
139 E Main St, Wilburton, Oklahoma. He can be reached at his office (for appointments etc.) via phone at
(918) 465-5727.
NPI number for Mr Robert Eugene Vandiver Ii is 1417090770 and his current mailing address is 139 E Main St, Wilburton, Oklahoma. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1417090770.
Provider's Profile
| Full Name | Mr Robert Eugene Vandiver Ii |
|---|
| Gender | Male |
|---|
| Speciality | Physician Assistant |
|---|
| Location | 139 E Main St, Wilburton, Oklahoma |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1417090770
- Provider Enumeration Date: 02/15/2007
- Last Update Date: 11/12/2007
Medical Identifiers
Medical identifiers for Mr Robert Eugene Vandiver Ii such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1417090770 | NPI | - | NPPES |
| 1417090770 | Other | OK | NPI |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 527 (Oklahoma) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Robert Eugene Vandiver Ii is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Robert Eugene Vandiver Ii, PA
139 E Main St,
Wilburton, OK 74578-4229
Ph: (918) 465-5727 | Mr Robert Eugene Vandiver Ii, PA
139 E Main St,
Wilburton, OK 74578-4229
Ph: (918) 465-5727 |
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