Provider Demographics
NPI:1457324477
Name:ROGGY, SHERI LYN (OD)
Entity Type:Individual
Prefix:DR
First Name:SHERI
Middle Name:LYN
Last Name:ROGGY
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 1:1060 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-6625
Mailing Address - Country:US
Mailing Address - Phone:319-338-9275
Mailing Address - Fax:319-338-2499
Practice Address - Street 1:1060 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6625
Practice Address - Country:US
Practice Address - Phone:319-338-9275
Practice Address - Fax:319-338-2499
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02114152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0174045Medicaid
IA410037808OtherRAILROAD MEDICARE
IA410037808OtherRAILROAD MEDICARE
IAU71272Medicare UPIN
IA0174045Medicaid