Provider Demographics
NPI:1104834886
Name:ROBY, AMBER (OD)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:
Last Name:ROBY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 N. ROBINSON
Mailing Address - Street 2:SUITE 130
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102
Mailing Address - Country:US
Mailing Address - Phone:405-232-0877
Mailing Address - Fax:405-232-5956
Practice Address - Street 1:211 N. ROBINSON
Practice Address - Street 2:SUITE 130
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102
Practice Address - Country:US
Practice Address - Phone:405-232-0877
Practice Address - Fax:405-232-5956
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2500152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK9892071OtherAETNA
OK200095670AMedicaid
OK2803373OtherUNITED HEALTHCARE
OK200095670AMedicaid
OK243724102Medicare PIN
OK9892071OtherAETNA