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Individual

ROGER K ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
106 E MEMORIAL DR, ELIZABETHTOWN, KY 42701-2502
(270) 769-6327
(270) 769-1574
Mailing address
1451 W LINCOLN TRAIL BLVD, NO. A CHRISTOPHER SQUARE, RADCLIFF, KY 40160-2548
(270) 351-4954

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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