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General NPI Number Information
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NPI Number | 1881844249
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Entity Type | Organization
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Legal Business Name | CURTIS E. ROBERSON,OD INC
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Dates
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Enumeration Date | 09/23/2008
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Last Update Date | 11/04/2008
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Provider Practice Location Address
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Address Line | 1221 S HOLLY AVE
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City | YUKON
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State | OK
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Zip | 73099-3839
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Country | US
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Telephone | 405-354-6614
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Fax | 405-354-6615
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Provider Business Mailing Address
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Address Line | 1221 S HOLLY AVE
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City | YUKON
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State | OK
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Zip | 73099-3839
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Country | US
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Telephone | 405-354-6614
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Fax | 405-354-6615
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Authorized Official
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Title or Position | OWNER-PRESIDENT
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Name | DR. CURTIS E. ROBERSON
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Credential | OD
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Telephone | 405-354-6614
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 855
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License Number State | OK
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