Individual
ROGER ISLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
651 COLLIERS WAY, SUITE 408, WEIRTON, WV 26062-5053
(304) 723-0005
(304) 723-0074
Mailing address
651 COLLIERS WAY, SUITE 203, WEIRTON, WV 26062-5053
(304) 723-6040
(304) 723-6039
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
10220
WV
207Y00000X
Otolaryngology Physician
35035903I
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101320000
—
WV
05
—
0322350
—
OH
Enumeration date
07/05/2005
Last updated
08/09/2013
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