Individual
LEROY SIMONS ROBERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
29 N MAIN ST, WAYNESVILLE, NC 28786-3886
(828) 456-8361
(828) 452-4527
Mailing address
29 N MAIN ST, WAYNESVILLE, NC 28786-3886
(828) 456-8361
(828) 452-4527
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0928
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09774
BC/BS
NC
01
—
1336121540
NPI
NC
01
—
22-70673
UHC
NC
05
—
8909774
—
NC
Enumeration date
11/15/2005
Last updated
08/24/2007
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