Provider Demographics
NPI:1386164697
Name:ISIGHT OPTOMETRY
Entity type:Organization
Organization Name:ISIGHT OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:316-681-0991
Mailing Address - Street 1:8150 E DOUGLAS AVE STE 50-60
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2376
Mailing Address - Country:US
Mailing Address - Phone:316-681-0991
Mailing Address - Fax:
Practice Address - Street 1:8150 E DOUGLAS AVE
Practice Address - Street 2:SUITE 50-60
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206
Practice Address - Country:US
Practice Address - Phone:316-681-0991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1201-3152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty