Basic Information
| Provider Information | |||||||||
| NPI: | 1720288475 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROACH FISHER AND ROACH PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 129 SOUTH WINTER STREET | ||||||||
| Address2: | PO BOX 277 | ||||||||
| City: | MIDWAY | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8598464445 | ||||||||
| FaxNumber: | 8598464761 | ||||||||
| Practice Location | |||||||||
| Address1: | 129 SOUTH WINTER STREET | ||||||||
| Address2: | |||||||||
| City: | MIDWAY | ||||||||
| State: | KY | ||||||||
| PostalCode: | 40347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8598464445 | ||||||||
| FaxNumber: | 8598464761 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2007 | ||||||||
| LastUpdateDate: | 03/14/2011 | ||||||||
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| AuthorizedOfficialLastName: | ROACH | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/ CFO | ||||||||
| AuthorizedOfficialTelephone: | 8598464445 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 21321 | KY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.