Individual
MARK ROARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
195 COMMERCIAL DR STE 98, LONDON, KY 40744-5200
(606) 878-1219
(606) 877-1195
Mailing address
195 COMMERCIAL DR STE 98, LONDON, KY 40744-5200
(606) 878-1219
(068) 771-1956
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3008480
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100294960
—
KY
Enumeration date
01/24/2014
Last updated
11/18/2024
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