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General NPI Number Information
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NPI Number | 1447221817
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Entity Type | Individual
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Provider Name | RONALD M ROAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 06/24/2011
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Provider Practice Location Address
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Address Line | 608 STONE AVENUE
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City | TALLADEGA
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State | AL
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Zip | 35610-2217
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Country | US
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Telephone | 205-979-5882
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Fax | 205-979-1248
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Provider Business Mailing Address
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Address Line | 1012 IRVING RD
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City | HOMEWOOD
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State | AL
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Zip | 35209-3428
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Country | US
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Telephone | 205-427-0691
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 24176
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 24176
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 24176
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | 24176
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License Number State | AL
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Taxonomy #5
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 24176
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License Number State | AL
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