Provider Demographics
NPI:1871608257
Name:MAUREY, ROXANNE (OD)
Entity type:Individual
Prefix:DR
First Name:ROXANNE
Middle Name:
Last Name:MAUREY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 EVENSVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:IN
Mailing Address - Zip Code:46135-1105
Mailing Address - Country:US
Mailing Address - Phone:765-653-8245
Mailing Address - Fax:765-653-5009
Practice Address - Street 1:5555 S US HIGHWAY 41
Practice Address - Street 2:WAL-MART VISION CENTER
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4715
Practice Address - Country:US
Practice Address - Phone:812-299-2959
Practice Address - Fax:812-299-5839
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18001975152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management