Healthcare Provider Details

I. General information

NPI: 1720288475
Provider Name (Legal Business Name): ROACH FISHER AND ROACH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 03/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 SOUTH WINTER STREET
MIDWAY KY
40347
US

IV. Provider business mailing address

129 SOUTH WINTER STREET PO BOX 277
MIDWAY KY
40347
US

V. Phone/Fax

Practice location:
  • Phone: 859-846-4445
  • Fax: 859-846-4761
Mailing address:
  • Phone: 859-846-4445
  • Fax: 859-846-4761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number21321
License Number StateKY

VIII. Authorized Official

Name: DR. JAMES P ROACH
Title or Position: OWNER/ CFO
Credential: MD
Phone: 859-846-4445