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Active NPI 1376536813 Individual Practitioner Male Practitioner

Dr. Phillip Warren Petterborg , OD

Optometrist • Dover Afb, DE

Professional Overview & Biography Verified Profile Summary

Dr. Phillip Petterborg, OD is a registered healthcare professional specializing in Optometrist in Dover Afb, DE. Practice services are available at 300 TUSKEGEE BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

300 Tuskegee Blvd

Dover Afb, DE 199025300

Telephone 3026772574
Fax 3026772526
Associated Practice Facility / Clinic
🏢 436th Medgrp-Dover Facility NPI 1437112646

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Dover Afb, DE

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.5 Yrs
Regional Practice Density
2 Specialists

Practicing in Dover Afb, DE (166 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License ID ODP-730

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1548254170

Doctor of Medicine (M.D.)

Dr. Cora Randle , MD

Internal Medicine

NPI 1558355420

Doctor of Medicine (M.D.)

Dr. Timothy Pendergrass , MD

Radiology - Diagnostic Radiology

NPI 1588651020

Doctor of Medicine (M.D.)

Nicole Fahs

Nurse Practitioner - Psychiatric/Mental Health

NPI 1700558913

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 300 TUSKEGEE BLVD, DOVER AFB, DE 199025300 (Tel: 3026772574)

📍
Updated Business Mailing Address July 08, 2007

Registered at 906 E PEBWORTH RD, MAGNOLIA, DE 199621848 (Tel: 3026976176)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as PHILLIP PETTERBORG, OD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Optometrist (License #ODP-730 in ID)

🟢
Initial NPI Registration & Enumeration August 30, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1376536813
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 30, 2005
Last Update: July 13, 2026
Sole Proprietor: No

Mailing Address

906 E Pebworth Rd

Magnolia, DE 199621848

Phone: 3026976176

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.