Thammavong, Roulay

Thammavong, Roulay is an individual health care provider with primary practice located at 200 N Breiel Blvd , Middletown OH 45042-3808. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Thammavong, Roulay can be contacted via phone (513) 424-2535.

Contact Information

Primary practice address
200 N Breiel Blvd Middletown OH 45042-3808
Phone: (513) 424-2535
Fax: (513) 424-0363
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 237174 New York
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD431273 Pennsylvania
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 35.093551 Ohio

Profile Details

NPI number 1609924984
LBN Legal business name Thammavong, Roulay
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2007
Last updated Mar 23rd, 2022 - about 4 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 1609924984 NPPES
Ohio MEDICAID 2799959

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