Individual
SCOT KIMBALL ROLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 E CHESTNUT ST, SUITE 303, LOUISVILLE, KY 40202-1831
(502) 629-5552
(502) 629-3132
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
42209
KY
208M00000X
Hospitalist Physician
Primary
42209
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200989460
—
IN
05
—
7100111860
—
KY
Enumeration date
03/08/2007
Last updated
07/09/2016
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