Provider Demographics
NPI:1952331696
Name:ROHR, JEFFREY SCOTT (DO)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:SCOTT
Last Name:ROHR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 E HILL RD
Mailing Address - Street 2:D
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-5420
Mailing Address - Country:US
Mailing Address - Phone:810-579-0202
Mailing Address - Fax:810-579-0204
Practice Address - Street 1:2240 E HILL RD
Practice Address - Street 2:D
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-5420
Practice Address - Country:US
Practice Address - Phone:810-579-0202
Practice Address - Fax:810-579-0204
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101012835174400000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI07225OtherMCARE
MI383540274OtherPPOM
MI4256288Medicaid
MI0988842OtherHEALTHPLUS
MI1852511004OtherBLUE CROSS/ BLUE SHIELD
MI0988842OtherHEALTHPLUS
MI383540274OtherPPOM