Individual
DR. JEFFREY BRENT ROATEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
6550
AK
2086S0120X
Pediatric Surgery Physician
43121
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD1272
—
AK
Enumeration date
01/07/2008
Last updated
02/04/2026
Update your record
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