Provider Demographics
NPI:1851477947
Name:AUBRY, ROBERT A (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:AUBRY
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:PO BOX 416
Mailing Address - Street 2:
Mailing Address - City:GRAYLING
Mailing Address - State:MI
Mailing Address - Zip Code:49738-0416
Mailing Address - Country:US
Mailing Address - Phone:989-348-3211
Mailing Address - Fax:989-348-7852
Practice Address - Street 1:904 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:GRAYLING
Practice Address - State:MI
Practice Address - Zip Code:49738-1308
Practice Address - Country:US
Practice Address - Phone:989-348-3211
Practice Address - Fax:989-348-7852
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003748152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4152566Medicaid
MI900B010050OtherBCBSM
MI129314001OtherMEDICARE DMEPOS
MIU63231Medicare UPIN
MI900B010050OtherBCBSM