Individual
DR. BRENT ALLEN ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 AUDUBON PLAZA DR, LOUISVILLE, KY 40217-1318
(502) 447-8786
(502) 447-8623
Mailing address
5129 DIXIE HWY STE 100, LOUISVILLE, KY 40216-1727
(502) 447-8786
(502) 447-8623
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD0000051186
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300017227
—
IN
05
—
7100478060
—
KY
Enumeration date
06/13/2012
Last updated
04/04/2024
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