| Roger D. Fannin, Od, Psc | |
|
313 S Carol Malone Blvd, Grayson, KY 41143-1357 | |
| (606) 474-7833 | |
| (606) 474-3563 |
| Full Name | Roger D. Fannin, Od, Psc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 313 S Carol Malone Blvd, Grayson, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114128667 | NPI | - | NPPES |
| 77901023 | Medicaid | KY | |
| DA4435 | Other | KY | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 1018DT (Kentucky) | Primary |
| Provider Name | Roger D Fannin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1407857766 PECOS PAC ID: 7113916453 Enrollment ID: I20040511000730 |
| Provider Name | Joshua C Arnett |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073351854 PECOS PAC ID: 1557893955 Enrollment ID: I20241010000153 |
| Mailing Address | Practice Location Address |
|---|---|
| Roger D. Fannin, Od, Psc 313 S Carol Malone Blvd, Po Box 485, Grayson, KY 41143-1357 Ph: (606) 474-7833 | Roger D. Fannin, Od, Psc 313 S Carol Malone Blvd, Grayson, KY 41143-1357 Ph: (606) 474-7833 |
Anthony Scott Kee, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 166 S Carol Malone Blvd, Ste A, Grayson, KY 41143 Phone: 606-474-2940 Fax: 606-474-2944 | |
Dr. Joshua C Arnett, OD Optometrist Medicare: Medicare Enrolled Practice Location: 313 S Carol Malone Blvd, Grayson, KY 41143 Phone: 606-474-7833 Fax: 606-474-3563 | |
Dr. Garrett Scott Kee, OD Optometrist Medicare: Medicare Enrolled Practice Location: 166 S Carol Malone Blvd Ste A, Grayson, KY 41143 Phone: 606-474-2940 | |
Dr. Mary Catherine West, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 313 S Carol Malone Blvd, Grayson, KY 41143 Phone: 606-474-7833 Fax: 606-474-3563 | |
Mccloud Eye Care Center Inc Optometrist Medicare: Medicare Enrolled Practice Location: 107 E Main St, Grayson, KY 41143 Phone: 606-474-5149 Fax: 606-474-0648 | |
Kee Eye Care Pllc Optometrist Medicare: Medicare Enrolled Practice Location: 166 S Carol Malone Blvd, Grayson, KY 41143 Phone: 606-474-2940 Fax: 606-474-2944 |