Roberts, Mallory Sanderfur
Roberts, Mallory Sanderfur is an sole proprietor health care provider with primary practice located at 255 Main St , Calhoun KY 42327-2104. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Roberts, Mallory Sanderfur can be contacted via phone (270) 273-3000.Contact Information
Primary practice address
255 Main St
Calhoun KY 42327-2104
Phone: (270) 273-3000
Fax: (270) 273-9252
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1421DT | Kentucky |
Profile Details
| NPI number | 1679668198 |
|---|---|
| LBN Legal business name | Roberts, Mallory Sanderfur |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 3rd, 2006 |
| Last updated | Jun 18th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679668198 | NPPES |
| Kentucky | MEDICAID | 77903375 | |
| Kentucky | MEDICAID | 77014215 |
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