Provider Demographics
NPI:1861577470
Name:ROBSON, ELIZABETH DALESANDRO (OD)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:DALESANDRO
Last Name:ROBSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:DALESANDRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:27520 HWY 98
Mailing Address - Street 2:WAL MART VISION CENTER
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-4812
Mailing Address - Country:US
Mailing Address - Phone:251-626-8950
Mailing Address - Fax:251-626-5896
Practice Address - Street 1:27520 HWY 98
Practice Address - Street 2:WAL MART VISION CENTER
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4812
Practice Address - Country:US
Practice Address - Phone:251-626-8950
Practice Address - Fax:251-626-5896
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALS965TA532152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U81909Medicare UPIN