Robert Alan Roush
Optometrist
781 E North Street
Kendallville
, Indiana 46755-1225
Robert Alan Roush
Optometrist
781 E North Street
Kendallville
, Indiana 46755-1225
(260) 347-4425
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Robert Alan Roush
- 781 E North Street
- Kendallville, IN
- Zip : 46755-1225
- Fax : (260) 347-4425
- Phone : (260) 347-3458
Second Address
- Robert Alan Roush
- 781 E North Street
- Kendallville, IN
- Zip : 46755-1225
- Fax : (260) 347-4425
- Phone : (260) 347-3458
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 18001875A | IN |
National Provider Identifier
| NPI | 1003811860 |
|---|---|
| Provider Name | Robert Alan Roush |
| First Address | Kendallville, IN 46755-1225 |
| Second Address | Kendallville, IN 46755-1225 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/06/2005 |
| Last Update Date | 20/07/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 100280550A | (05) | IN |
| 100355140A | (05) | IN |
| T83733 | (02) | IN |
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.