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NPI Code Detail

MEDICARE: DAVID R ROSE OD & ASSOC PC

MEDICARE: DAVID R ROSE OD & ASSOC PC
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
1152W00000XOptometrist0618001451VA

General Provider Information

NPI Number : 1659686921
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAVID R ROSE OD & ASSOC PC
Provider Business Mailing Address
First Line : 1800 CARL D SILVER PKWY
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22401-4960
Country : US
Telephone Number : 540-786-8186
Fax Number : 540-786-8538
Provider Business Practice Location Address
First Line : 1800 CARL D SILVER PKWY
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22401-4960
Country : US
Telephone Number : 540-786-8186
Fax Number : 540-786-8538
Authorized Official
Title or Position : CEO
Name : DR. DAVID R. ROSE
Credential : O.D.
Telephone Number : 540-786-8186
Provider Enumeration Date : 08/11/2010
Last Update Date : 05/12/2011

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