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General NPI Number Information
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NPI Number | 1447482369
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Entity Type | Organization
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Legal Business Name | ROBYN L. DRAGOO, OD PC
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Dates
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Enumeration Date | 08/11/2009
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Last Update Date | 08/11/2009
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Provider Practice Location Address
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Address Line | 27600 NOVI RD
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City | NOVI
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State | MI
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Zip | 48377-3420
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Country | US
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Telephone | 248-348-1032
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Fax | 248-348-3593
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Provider Business Mailing Address
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Address Line | 4049 W MAPLE RD
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City | WIXOM
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State | MI
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Zip | 48393-1713
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Country | US
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Telephone | 248-348-1032
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Fax | 248-348-3593
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | ROBYN L DRAGOO
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Credential | O.D.
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Telephone | 248-348-1032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 4901003870
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901003870
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License Number State | MI
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