Provider Demographics
NPI:1649667122
Name:BURTCH, ROBERT III (OD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:BURTCH
Suffix:III
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-5305
Mailing Address - Country:US
Mailing Address - Phone:315-529-6894
Mailing Address - Fax:
Practice Address - Street 1:205 LAKE AVE
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2628
Practice Address - Country:US
Practice Address - Phone:518-584-6111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-22
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002997152W00000X
NH0905152W00000X
NYTUV009508152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist