Individual
DR. ROGER LEA HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2801 NEW HARTFORD RD, OWENSBORO, KY 42303-1320
(270) 683-3720
(270) 686-7331
Mailing address
2801 NEW HARTFORD RD, OWENSBORO, KY 42303-1320
(270) 683-3720
(270) 686-7331
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01046282A
IN
208600000X
Surgery Physician
Primary
19761
KY
2086S0129X
Vascular Surgery Physician
01046282A
IN
2086S0129X
Vascular Surgery Physician
19761
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000048413
ANTHEM
KY
01
—
020038275
RAILROAD MEDICARE
—
01
—
200132180
MOLINA
IN
05
—
200132180
—
IN
01
—
611059472
DART
KY
01
—
611059472
UMWA
—
01
—
6110594722109
CARESOURCE
IN
05
—
64197619
—
KY
Enumeration date
07/20/2005
Last updated
11/27/2023
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