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Individual

RONALD ROACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
100 JACKSON PIKE, GALLIPOLIS, OH 45631
(855) 446-5937
(740) 446-5486
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1562
(740) 441-1949
(740) 446-5982

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.019706
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810004370
WV
01
P00275516
R MEDICARE
WV
Enumeration date
10/24/2006
Last updated
03/01/2024
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