Larry Brandon Roark Nurse Practitioner
2317 Cumberland Ave, Middlesboro, KY 40965-2834


Larry Brandon Roark is physician registered in the Centers for Medicare & Medicaid Services (CMS). The National Provider Identifier (NPI) of the National Plan and Provider Enumeration System (NPPES) is 1437281649. The unique individual professional ID assigned by Provider Enrollment, Chain, and Ownership System (PECOS) is 6800989195. The primary specialty is NURSE PRACTITIONER. The organization is TRISTATE MEDICAL CLINIC INC. The address is 2317 Cumberland Ave, Middlesboro, KY 40965-2834. The zip code is 40965.


Larry Brandon Roark · 2317 Cumberland Ave, Middlesboro, KY 40965-2834

Nation Provider ID 1437281649
PAC ID by PECOS 6800989195
Professional Enrollment ID I20070831000321
Last Name ROARK
First Name LARRY
Middle Name BRANDON
Gender M
Medical School Name OTHER
Graduation Year 2006
Primary Specialty NURSE PRACTITIONER
Primary Specialty TRISTATE MEDICAL CLINIC INC
Phone Number 6062423100
Group Practice PAC ID 5890713424
Address 2317 CUMBERLAND AVE
MIDDLESBORO, KY 409652834
Claims Based Hospital Affiliation Claim Control Number (CCN): 180020
Legal Business Name: MIDDLESBORO APPALACHIAN REGIONAL HEALTHCARE HOSPIT
Claims Based Hospital Affiliation Claim Control Number (CCN): 180021
Legal Business Name: PINEVILLE COMMUNITY HOSPITAL
Professional accepts Medicare Assignment Y
Report Quality Measures Y

street_number: 2317
route: West Cumberland Avenue (W Cumberland Ave)
locality, political: Middlesboro
admin_level_2, political: Bell County
admin_level_1, political: Kentucky (KY)
country, political: United States (US)
postal_code: 40965
postal_code_suffix: 2834
types : street_address
latitude: 36.6066949
longitude: -83.7196294
latlng: (36.6066949, -83.7196294)


Zip 40965 · Nurse Practitioner · Medicare Physician

Name Address Specialty
Radwa Martin 3602 W Cumberland Ave, Middlesboro, KY 40965-2614 NURSE PRACTITIONER
Aimee Brock 123 N 19th St, Middlesboro, KY 40965-2865 NURSE PRACTITIONER
Marcina Bailey 235 New Wilson Lane, Middlesboro, KY 40965 NURSE PRACTITIONER
Carolyn Davis Rutherford 3602 W Cumberland Ave, Middlesboro, KY 40965-2614 NURSE PRACTITIONER
Karen Mcdaniel 3004 Cumberland Ave, Middlesboro, KY 40965-2343 NURSE PRACTITIONER
Kimberly Langub 2010 Cumberland Ave, Middlesboro, KY 40965-2829 NURSE PRACTITIONER
Samuel Bayless 2315 Cumberland Ave, Middlesboro, KY 40965-2834 NURSE PRACTITIONER
Jessica Helton 3004 Cumberland Ave, Middlesboro, KY 40965-2343 NURSE PRACTITIONER
Christy Johnson 3600 Cumberland Ave, Middlesboro, KY 40965-2614 NURSE PRACTITIONER
Johnnie Watts 3600 Cumberland Ave, Middlesboro, KY 40965-2614 NURSE PRACTITIONER

Zip 40965 · Medicare Physician

Name Address Specialty
Kevin Stanley 3600 W Cumberland Ave, Middlesboro, KY 40965-2614 CERTIFIED REGISTERED NURSE ANESTHETIST
Christy Johnson 3600 Cumberland Ave, Middlesboro, KY 40965-2614 NURSE PRACTITIONER
James Bland 3600 Cumberland Ave, Middlesboro, KY 40965-2614 OTOLARYNGOLOGY
Kayla Dye 705 N 12th St, Middlesboro, KY 40965-1835 PHYSICIAN ASSISTANT
Neil Barry 3004 Cumberland Ave, Middlesboro, KY 40965-2343 INTERNAL MEDICINE
Joseph Slusher 3600 Cumberland Ave, Middlesboro, KY 40965-2614 DIAGNOSTIC RADIOLOGY
James Corum 1475 Us Hwy 25 E, Middlesboro, KY 40965-2077 PHYSICAL THERAPY
Marcina Bailey 235 New Wilson Lane, Middlesboro, KY 40965 NURSE PRACTITIONER
Samuel Bayless 2315 Cumberland Ave, Middlesboro, KY 40965-2834 NURSE PRACTITIONER
Samuel Bailey 3600 Cumberland Ave, Middlesboro, KY 40965-2614 HEMATOLOGY/ONCOLOGY
Charles Moore 123 N 19th St, Middlesboro, KY 40965-2865 INTERNAL MEDICINE
Meredith Masoner 3600 Cumberland Ave, Middlesboro, KY 40965-2614 CERTIFIED NURSE MIDWIFE
William Minteer 3004 Cumberland Ave, Middlesboro, KY 40965-2343 CARDIOVASCULAR DISEASE (CARDIOLOGY)
Kaitlyn Shields 3600 W Cumberland Ave, Middlesboro, KY 40965-2614 CERTIFIED REGISTERED NURSE ANESTHETIST
Mohamad Alnahhas 3602 W Cumberland Ave, Middlesboro, KY 40965-2614 PEDIATRIC MEDICINE
Albert Holmes 473 N 12th St, Middlesboro, KY 40965-1133 OPHTHALMOLOGY
Nitinkumar Patel 3004 Cumberland Ave, Middlesboro, KY 40965-2343 INTERNAL MEDICINE
Bryan Jernigan 3600 W Cumberland Ave, Middlesboro, KY 40965-2614 CERTIFIED REGISTERED NURSE ANESTHETIST
David Sanford 1502 Cumberland Ave, Middlesboro, KY 40965-1223 OPHTHALMOLOGY
Robert Thomas 3004 Cumberland Ave, Middlesboro, KY 40965-2343 GENERAL SURGERY