Dr. Roy William Backus
Optometrist
200 12th St Sw
Forest Lake
, Minnesota 55025-1482
Dr. Roy William Backus
Optometrist
200 12th St Sw
Forest Lake
, Minnesota 55025-1482
(651) 237-0330
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Dr. Roy William Backus
- 38050 Jeffery Ave
- North Branch, MN
- Zip : 55056-5908
- Phone : (651) 237-0330
Second Address
- Dr. Roy William Backus
- 200 12th St Sw
- Forest Lake, MN
- Zip : 55025-1482
- Fax : (651) 464-9062
- Phone : (651) 464-9767
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2520 | MN |
National Provider Identifier
| NPI | 1003922030 |
|---|---|
| Provider Name | Dr. Roy William Backus |
| First Address | North Branch, MN 55056-5908 |
| Second Address | Forest Lake, MN 55025-1482 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/08/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 12060 | SPECTERA (01) | MN |
| 152144 | COLE VISION (01) | MN |
| 212298 | BCBS OPTI CHOICE # (01) | MN |
| 22-14902 | MEDICA (01) | MN |
| 4100006627 | (05) | MN |
| 410042867 | RAILROAD PROVIDER # (01) | MN |
| 48705 | DAVIS VISION (01) | MN |
| 489437500 | MN HEALTH CARE PROVIDER # (01) | MN |
| 6C258BA | BCBS (01) | MN |
| 71-0415188 | SUPERIOR VISION (01) | MN |
| U58325 | (02) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.