Organization
ROGER L ROARK, MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER LEE ROARK MD (OWNER)
(704) 873-2516
Entity
Organization
Contact information
Practice address
555 KITCHINGS DR STE C, STATESVILLE, NC 28677-3576
(704) 873-2516
(704) 873-1431
Mailing address
555 KITCHINGS DR STE C, STATESVILLE, NC 28677-3576
(704) 873-2516
(704) 873-1431
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20190
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71981
BCBS
NC
05
—
79-71981
—
NC
Enumeration date
08/27/2010
Last updated
08/27/2010
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