MEDICARE: DR CLIFFORD ROFFIS AND ASSOCIATES ODPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	0618000234	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DA5536	OTHER	VA	RAILROAD MEDICARE PIN
5	T21362	OTHER	VA	RAILROAD MEDICARE UPIN
10	P00063025	OTHER	VA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	106770	OTHER	VA	ANTHEM
3	465284	OTHER	VA	AETNA US HEALTHCARE
4	34796	OTHER	VA	DAVIS
6	VA1073	OTHER	VA	EYEMED VISION CARE
7	276556	OTHER	VA	SOUTHERN HEALTH
8	314973	OTHER	VA	ALLIANCE PPO
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184788457
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR CLIFFORD ROFFIS AND ASSOCIATES ODPC

Provider Business Mailing Address
First Line	:	4811 S LABURNUM AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23231-2713
Country	:	US
Telephone Number	:	804-226-1144
Fax Number	:	804-236-9026

Provider Business Practice Location Address
First Line	:	4811 S LABURNUM AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23231-2713
Country	:	US
Telephone Number	:	804-226-1144
Fax Number	:	804-236-9026

Authorized Official
Title or Position	:	OWNER
Name	:	CLIFFORD ROFFIS
Credential	:
Telephone Number	:	804-226-1144

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	06/21/2018

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Directions to “DR CLIFFORD ROFFIS AND ASSOCIATES ODPC ” Practice Location

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