Provider Demographics
NPI:1972310266
Name:ARMSTRONG, ROGER LEE
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:LEE
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 NW 174TH ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-6790
Mailing Address - Country:US
Mailing Address - Phone:479-462-7485
Mailing Address - Fax:
Practice Address - Street 1:541 NW 174TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-6790
Practice Address - Country:US
Practice Address - Phone:479-462-7485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist