Davis, Roger Glen
Davis, Roger Glen is an individual health care provider with primary practice located at 235 Harvey St , Winston Salem NC 27103-1741. He recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as his primary health care specialty. Davis, Roger Glen can be contacted via phone (336) 842-0952.Contact Information
Primary practice address
235 Harvey St
Winston Salem NC 27103-1741
Phone: (336) 842-0952
Fax: (336) 793-3475
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 1286 | North Carolina |
Profile Details
| NPI number | 1205859832 |
|---|---|
| LBN Legal business name | Davis, Roger Glen |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 25th, 2006 |
| Last updated | Jun 4th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205859832 | NPPES |
| North Carolina | MEDICAID | 7909122 |
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