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General NPI Number Information
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NPI Number | 1932102340
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Entity Type | Individual
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Provider Name | WILLIAM ROBERT ROSCOE O.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 02/28/2014
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Provider Practice Location Address
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Address Line | 2500 METROHEALTH DR
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City | CLEVELAND
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State | OH
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Zip | 44109-1900
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Country | US
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Telephone | 216-778-5830
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Fax |
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Provider Business Mailing Address
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Address Line | 3041 RAVINEVIEW CIR
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City | STOW
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State | OH
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Zip | 44224-5543
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Country | US
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Telephone | 330-342-7777
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3370, T-103
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License Number State | OH
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