DR. Roger D. Fannin, O.D.

NPI #1407857766 in Grayson, Kentucky

Provider Information

NPI Number: 1407857766
Entity Type: Individual
Name: DR. Roger D. Fannin, O.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Aug 9, 2005
Last Updated: Apr 14, 2023

Practice Location

Address: 313 S CAROL MALONE BLVD
City: Grayson
State: Kentucky
ZIP Code: 41143-1357
Phone: (606) 474-7833

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X
Optometrist	152W00000X	Primary

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