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Dr. Roger D. Fannin, OD
Optometrist in Grayson, Kentucky
NPI 1407857766

Roger D. Fannin is a Optometrist based in Grayson, KY. Roger D. Fannin practices in Grayson, KY and has the professional credentials of OD. The NPI Number for Roger D. Fannin is 1407857766 and holds a License No. KY1018DT (Kentucky).

The current practice location address for Roger D. Fannin is 313 S Carol Malone Blvd, Grayson, KY and can be reached out via phone at 606-474-7833 and via fax at 606-474-3563.

Location: 313 S Carol Malone Blvd, Grayson, KY, 41143-1357
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407857766
Provider Name
Roger D. Fannin
Credential
OD
Provider Entity Type
Individual
Gender
Male
Address
313 S Carol Malone Blvd, Grayson, KY, 41143-1357
Phone Number
606-474-7833
Fax Number
606-474-3563
Provider Enumeration Date
08/09/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
77010189 05 KY
5965025 01 KY AETNA
45775780 01 KY EPSDT
000000048519 01 KY ANTHEM
611071677 01 FEDERAL TAX ID
P00059060 01 KY RR MEDICARE PTAN
2272760 01 FIRST HEALTH INS. CO
institution
Provider Business Practice Location Address Details
Address
313 S Carol Malone Blvd
City
Grayson
State
Kentucky
Zip
41143-1357
Phone Number
606-474-7833
Fax Number
606-474-3563
person
Provider Business Mailing Address Details
Address
313 S Carol Malone Blvd
City
Grayson
State
Kentucky
Zip
41143-1357
Phone Number
606-474-7833
Fax Number
606-474-3563
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Optometrist
Speciality
-
Taxonomy
152W00000X
License No.
1018DT (Kentucky)
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Eyewear Supplier
Speciality
-
Taxonomy
332H00000X
License No.
KY1018DT (Kentucky)
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
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