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NPI Code Detail

MEDICARE: DR. WILLIAM ROBERT ROSCOE O.D., PH.D.

MEDICARE: DR. WILLIAM ROBERT ROSCOE O.D., PH.D.
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
1152W00000XOptometrist3370, T-103OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932102340
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM ROBERT ROSCOE O.D., PH.D.
Provider Business Mailing Address
First Line : 3041 RAVINEVIEW CIR
Second Line :
City : STOW
State : OH
Zip : 44224-5543
Country : US
Telephone Number : 330-342-7777
Fax Number :
Provider Business Practice Location Address
First Line : 2500 METROHEALTH DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-1900
Country : US
Telephone Number : 216-778-5830
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 02/28/2014

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