Healthcare Provider Details

I. General information

NPI: 1215129069
Provider Name (Legal Business Name): ROBERTSON & KOENIG, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 04/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 S MAIN ST
YERINGTON NV
89447-2536
US

IV. Provider business mailing address

233 S MAIN ST
YERINGTON NV
89447-2536
US

V. Phone/Fax

Practice location:
  • Phone: 775-463-2020
  • Fax: 775-463-1965
Mailing address:
  • Phone: 775-463-2020
  • Fax: 775-463-1965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateNV

VIII. Authorized Official

Name: DR. CARL D ROBERTSON
Title or Position: PRESIDENT
Credential: O.D.
Phone: 775-423-8024