Individual
DR. ROBERT ELAM BOTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
606 POWELL AVE E, BIG STONE GAP, VA 24219-2348
(276) 523-4414
(276) 523-4414
Mailing address
PO DRAWER BB, BIG STONE GAP, VA 24219-0660
(276) 523-4414
(276) 523-4414
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000016
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009201068
—
VA
05
—
009204334
—
VA
01
—
021081
ANTHEM BSG
VA
01
—
098665
ANTHEM PENNINGTON
VA
01
—
38670
DAVIS VISION
VA
Enumeration date
03/05/2007
Last updated
02/11/2009
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