Individual
CAROL ROARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
215 E 11TH ST, NEWPORT, KY 41071-2203
(859) 655-6100
(859) 655-6186
Mailing address
215 E 11TH ST, NEWPORT, KY 41071-2203
(859) 655-6100
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
22479
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64224793
—
KY
Enumeration date
07/18/2005
Last updated
03/15/2021
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