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Individual
TIMOTHY ROACH
Active
Individual
TIMOTHY ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
04084
KY
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
OS020426
PA
Other
Enumeration date
05/13/2014
Last updated
07/15/2020
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