Organization
DR. JOHN D. ROBERTS, OD PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ROBERTS OD (OWNER)
(270) 351-8661
Entity
Organization
Contact information
Practice address
472 W LINCOLN TRAIL BLVD, RADCLIFF, KY 40160-2047
(270) 351-8661
(270) 351-8713
Mailing address
472 W LINCOLN TRAIL BLVD, RADCLIFF, KY 40160-2047
(270) 351-8661
(270) 351-8713
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1048DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77010486
—
KY
Enumeration date
07/15/2013
Last updated
07/15/2013
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