Kern, Roger M.

Kern, Roger M. is an individual health care provider with primary practice located at 564 N Idaho Rd , Apache Junction AZ 85219-4001. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Kern, Roger M. can be contacted via phone (480) 288-5328.

Contact Information

Primary practice address
564 N Idaho Rd Apache Junction AZ 85219-4001
Fax: (480) 288-5339
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LISAC 10208 Arizona

Profile Details

NPI number 1811045420
LBN Legal business name Kern, Roger M.
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2007
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811045420 NPPES
Arizona MEDICAID 164397

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