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Individual

ROGER K COLBERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
4305 NEW SHEPHERDSVILLE RD, BARDSTOWN, KY 40004-9019
(502) 350-5000
Mailing address
PO BOX 1160, BARDSTOWN, KY 40004-4160
(859) 276-6611

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1053494
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000271994
BCBS
KY
05
74346503
KY
Enumeration date
05/28/2006
Last updated
09/23/2011
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