Dr. Mallory Sanderfur Roberts
Optometrist
255 Main St
Calhoun
, Kentucky 42327-2104
Dr. Mallory Sanderfur Roberts
Optometrist
255 Main St
Calhoun
, Kentucky 42327-2104
(270) 273-9252
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Dr. Mallory Sanderfur Roberts
- Po Box 411
- Calhoun, KY
- Zip : 42327-0411
- Fax : (270) 273-9252
- Phone : (270) 273-3000
Second Address
- Dr. Mallory Sanderfur Roberts
- 255 Main St
- Calhoun, KY
- Zip : 42327-2104
- Fax : (270) 273-9252
- Phone : (270) 273-3000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 1421DT | KY |
National Provider Identifier
| NPI | 1679668198 |
|---|---|
| Provider Name | Dr. Mallory Sanderfur Roberts |
| First Address | Calhoun, KY 42327-0411 |
| Second Address | Calhoun, KY 42327-2104 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/10/2006 |
| Last Update Date | 18/06/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 77014215 | (05) | KY |
| 77903375 | (05) | KY |
| U73459 | (02) | KY |
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.