Individual
DR. CRAIG A ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1705 PROSPECT DR, MACON, MO 63552-2602
(660) 385-5724
(660) 385-3924
Mailing address
30234 LAUREL PL, MACON, MO 63552-3803
(660) 385-4182
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T03114
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
250705
HEALTHLINK
MO
Enumeration date
02/28/2007
Last updated
07/08/2007
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