Organization Name: | JOHN D ROBERTS MDPC |
NPI Number: | 1063694412 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENNIFER A ROBERTS (MANAGER) |
Mailing Address: | 917 Plaza Ave Eastman |
State: | GA US |
Postal Code: | 310236759 |
Phone Number: | 4783749767 |
Fax Number: | 4783749769 |
NPI Enumeration Date: | 11/28/2007 |
NPI Last Update Date: | 02/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | 047253 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |