Individual
ROGER K ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
20484
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000064452
ANTHEM
KY
01
—
070013536
RAILROAD MEDICARE
KY
01
—
1102843
PASSPORT
KY
01
—
1194646
CHA
KY
01
—
2436324000
PASSPORT ADVANTAGE
KY
01
—
4643142
AETNA
KY
05
—
64204845
—
KY
Enumeration date
12/19/2005
Last updated
02/03/2014
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