Healthcare Provider Details

I. General information

NPI: 1902815814
Provider Name (Legal Business Name): ROGER ALAN FLEISCHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 09/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE STREET CC180A ROACH BLDG. UK HEMATOLOGY CLINIC
LEXINGTON KY
40536-0093
US

IV. Provider business mailing address

B412 VA HOSPITAL COOPER DRIVE INTERNAL MEDICINE
LEXINGTON KY
40502-2142
US

V. Phone/Fax

Practice location:
  • Phone: 859-257-6006
  • Fax: 859-257-6002
Mailing address:
  • Phone: 859-257-6006
  • Fax: 859-257-6002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number29871
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number29871
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number29871
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number29871
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number29871
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: