Roark, Mark

Roark, Mark is an individual health care provider with primary practice located at 195 Commercial Dr Ste 98 , London KY 40744-5200. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Roark, Mark can be contacted via phone (606) 878-1219.

Contact Information

Primary practice address
195 Commercial Dr Ste 98 London KY 40744-5200
Phone: (606) 878-1219
Fax: (606) 877-1195
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 3008480 Kentucky

Profile Details

NPI number 1518380625
LBN Legal business name Roark, Mark
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2014
Last updated Jan 31st, 2024 - about 2 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 1518380625 NPPES
Kentucky MEDICAID 7100294960

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