Healthcare Provider Details

I. General information

NPI: 1952331696
Provider Name (Legal Business Name): JEFFREY SCOTT ROHR D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 11/25/2020
Certification Date: 11/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 E HILL RD D
GRAND BLANC MI
48439-5420
US

IV. Provider business mailing address

2240 E HILL RD D
GRAND BLANC MI
48439-5420
US

V. Phone/Fax

Practice location:
  • Phone: 810-579-0202
  • Fax: 810-579-0204
Mailing address:
  • Phone: 810-579-0202
  • Fax: 810-579-0204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number5101012835
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number5101012835
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: