West, Roger

West, Roger is an individual health care provider with primary practice located at 1001 N Grand Ave , Tahlequah OK 74464-7017. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. West, Roger can be contacted via phone (918) 458-2109.

Contact Information

Primary practice address
1001 N Grand Ave Tahlequah OK 74464-7017
Fax: (918) 458-2310
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1097 Oklahoma

Profile Details

NPI number 1114947546
LBN Legal business name West, Roger
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Jul 8th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114947546 NPPES
Oklahoma MEDICAID 100767790A

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