Provider Demographics
NPI:1013980515
Name:ROPER, ARLYNN B (OD)
Entity Type:Individual
Prefix:
First Name:ARLYNN
Middle Name:B
Last Name:ROPER
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 1:4800 N 22ND ST STE 210
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4963
Mailing Address - Country:US
Mailing Address - Phone:480-892-8400
Mailing Address - Fax:602-508-4830
Practice Address - Street 1:6101 S RURAL RD STE 115
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-2910
Practice Address - Country:US
Practice Address - Phone:480-517-0047
Practice Address - Fax:602-508-4830
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOPT-000903152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ22702Medicare ID - Type Unspecified
AZZ22702Medicare PIN
AZZ22722Medicare PIN