Roger L Petersen OD
Organization Active NPI Optometrist · Higginsville, MO
NPI 1992829006 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1992829006
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- TO2272 (MO)
- Legal business name
- ROGER L PETERSEN OD
- Practice address
- 1817 N Main St
Higginsville, MO 64037-1524 - Phone
- (660) 584-2956
- Fax
- (660) 584-3956
- NPI assigned
- Mar 16, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Roger Leslie Petersen, OD
- Title
- Owner
- Phone
- (660) 584-2956
National Provider Directory
Locations
1817 Main St
Higginsville, MO 64037
Phone (660) 584-2956
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | TO2272 | MO | Yes |
Addresses
Primary practice location
1817 N Main St
Higginsville, MO 64037-1524
Mailing address
1817 N Main St
Higginsville, MO 64037-1524
Phone (660) 584-2956
Other providers in Higginsville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.