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Individual

DR. ROGER E TELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1500 JAMES SIMPSON JR WAY, COVINGTON, KY 41011-0801
(859) 655-1100
(859) 655-1102
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 655-1100
(859) 655-1102

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
01039670A
IN
207RI0200X
Infectious Disease Physician
Primary
33494
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64343940
KY
Enumeration date
06/12/2006
Last updated
08/23/2023
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