NPI 1093979874 · live from the CMS NPI Registry
Roger Marvin Allyn, O.D.
Optometrist in La Plata, NM. National Provider Identifier 1093979874, active.
NPI record
| NPI | 1093979874 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 1170 Hwy 170, La Plata, NM 87418 |
| Practice phone | 505-325-2472 |
| Mailing address | Po Box 269, La Plata, NM 87418 |
| Enumerated | July 11, 2008 |
| Last updated | July 11, 2008 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 2219 OP (NM) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.