Provider Demographics
NPI:1427057868
Name:ROOFE, FRANK ERNEST III (OD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:ERNEST
Last Name:ROOFE
Suffix:III
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 1:509 E LAUCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-5502
Mailing Address - Country:US
Mailing Address - Phone:910-276-9256
Mailing Address - Fax:910-276-9254
Practice Address - Street 1:509 E LAUCHWOOD DR
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5502
Practice Address - Country:US
Practice Address - Phone:910-276-9256
Practice Address - Fax:910-276-9254
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1022152W00000X, 152WC0802X, 152WP0200X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC09773OtherNC BCBS
NC20-5212044OtherEMPLOYER IDENTIFICATION N
NC410047692OtherRAILROAD MEDICARE
NC561288835OtherFEDERAL ID#
NC8909773Medicaid
NC8909773Medicaid
NC20-5212044OtherEMPLOYER IDENTIFICATION N