Healthcare Provider Details

I. General information

NPI: 1992735658
Provider Name (Legal Business Name): JEFFREY S. ROHR, D.O., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 E HILL RD STE 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 TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number5101012835
License Number StateMI

VIII. Authorized Official

Name: LISA DRAYTON
Title or Position: OFFICE MANAGER
Credential:
Phone: 810-579-0202