Organization
ROSCOE OPTOMETRIC CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM DOUGLAS ROSCOE O.D. (OWNER/OPTOMETRIST)
(919) 776-2712
Entity
Organization
Contact information
Practice address
420 W MAIN ST, SANFORD, NC 27332-5924
(919) 776-2712
(919) 775-3486
Mailing address
PO BOX 3517, SANFORD, NC 27331-3517
(919) 776-2712
(919) 775-3486
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0969
NC
332H00000X
Eyewear Supplier
0969
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09776
BCBSNC
NC
05
—
7909776
—
NC
Enumeration date
11/26/2007
Last updated
11/17/2011
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