Individual
DR. KYLE V ROACH
Active
Individual
DR. KYLE V ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD34252
TN
207L00000X
Anesthesiology Physician
MD45115
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3152236
BCBS
TN
05
—
3852604
—
TN
01
—
4347082
BC BS OF TN
TN
Enumeration date
02/22/2006
Last updated
09/17/2013
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