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NPI Code Detail

MEDICARE: DR. CLIFFORD ALAN ROFFIS OD

MEDICARE:  DR. CLIFFORD ALAN ROFFIS  OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist0618000234VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DA5536OTHERVARAILROAD MEDICARE PIN
3T21362OTHERVARAILROAD MEDICARE UPIN
4541783118OTHERVARAILROAD MEDICARE TAX ID
5P00063025OTHERVARAILROAD MEDICARE
6541783118OTHERVAMEDICARE TAX ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2VA1073OTHERVAEYEMED VISION CARE
7541783118002OTHERVACIGNA
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9314973OTHERVAALLIANCE PPO
1034796OTHERVADAVIS VISION
11276556OTHERVASOUTHERN HEALTH
12465284OTHERVAAETNA US HEALTHCARE
13106770OTHERVAANTHEM

General Provider Information

NPI Number : 1114991460
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CLIFFORD ALAN ROFFIS OD
Provider Business Mailing Address
First Line : 4811 S LABURNUM AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23231-2713
Country : US
Telephone Number : 804-226-1144
Fax Number : 804-236-9026
Provider Business Practice Location Address
First Line : 4811 S LABURNUM AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23231-2713
Country : US
Telephone Number : 804-226-1144
Fax Number : 804-236-9026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2006
Last Update Date : 05/21/2013

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Directions to “ DR. CLIFFORD ALAN ROFFIS OD” Practice Location

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