Individual
MR. ROGER WAYNE LUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
211 W BROAD AVE, ROCKINGHAM, NC 28379-3529
(910) 997-4949
(910) 997-4111
Mailing address
PO BOX 121, NORMAN, NC 28367-0121
(910) 652-5664
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
398
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1234K
BCBS STATE HEALTH PLAN
NC
05
—
8801757
—
NC
01
—
Y1925
SERVICES FOR BLIND
NC
Enumeration date
11/03/2006
Last updated
07/08/2007
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