Individual
ROGER B ETHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M..D.
Contact information
Practice address
371 W CENTRAL AVE, COOLIDGE, AZ 85128-4706
(520) 723-3000
(520) 723-5393
Mailing address
4800 N 22ND ST STE 210, PHOENIX, AZ 85016-4963
(480) 892-8400
(602) 508-4830
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
552
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
034273
—
AZ
Enumeration date
02/02/2006
Last updated
07/30/2020
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