Roach, John M.
Roach, John M. is an sole proprietor health care provider with primary practice located at 242 Berger Rd , Paducah KY 42003-4522. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Roach, John M. can be contacted via phone (270) 366-0960.Contact Information
Primary practice address
242 Berger Rd
Paducah KY 42003-4522
Phone: (270) 366-0960
Fax: (271) 554-1108
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 39216 | Kentucky |
Profile Details
| NPI number | 1164425831 |
|---|---|
| LBN Legal business name | Roach, John M. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 24th, 2005 |
| Last updated | Oct 8th, 2019 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164425831 | NPPES |
| Kentucky | Other | 39216 | KY STATE LICENSE |
| Kentucky | MEDICAID | 64095565 | KY STATE LICENSE |
| Kentucky | Other | 1427478700 | KY STATE LICENSE |
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