Provider Demographics
NPI:1114991460
Name:ROFFIS, CLIFFORD ALAN (OD)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:ALAN
Last Name:ROFFIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4811 S LABURNUM AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-2713
Mailing Address - Country:US
Mailing Address - Phone:804-226-1144
Mailing Address - Fax:804-236-9026
Practice Address - Street 1:4811 S LABURNUM AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-2713
Practice Address - Country:US
Practice Address - Phone:804-226-1144
Practice Address - Fax:804-236-9026
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000234152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADA5536OtherRAILROAD MEDICARE PIN
VAVA1073OtherEYEMED VISION CARE
VAT21362OtherRAILROAD MEDICARE UPIN
VA541783118OtherRAILROAD MEDICARE TAX ID
VAP00063025OtherRAILROAD MEDICARE
VA541783118OtherMEDICARE TAX ID
VA541783118002OtherCIGNA
VA9205403Medicaid
VA314973OtherALLIANCE PPO
VA34796OtherDAVIS VISION
VA276556OtherSOUTHERN HEALTH
VA465284OtherAETNA US HEALTHCARE
VA106770OtherANTHEM
VAVA1073OtherEYEMED VISION CARE
VAT21362Medicare UPIN