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
Group Practice PAC ID 5890713424
Number of Group Practice Members 1
Address 2317 CUMBERLAND AVE
MIDDLESBORO, KY 409652834
Claims Based Hospital Affiliation Claim Control Number (CCN): 180020
Legal Business Name: APPALACHIAN REGIONAL HEALTHCARE INC
Claims Based Hospital Affiliation Claim Control Number (CCN): 180021
Legal Business Name: PINEVILLE COMMUNITY HOSPITAL ASSN INC
Professional accepts Medicare Assignment Y

Zip 40965 · Nurse Practitioner · Medicare Physician

Name Address Specialty
Brenda Carey 123 N 19th St, Middlesboro, KY 40965 NURSE PRACTITIONER
Amy Goodin 3004 Cumberland Ave, Middlesboro, KY 40965 NURSE PRACTITIONER
Marcina Bailey 123 N 19th St, Middlesboro, KY 40965 NURSE PRACTITIONER
Corey Payne 3600 W Cumberland Ave, Middlesboro, KY 40965 NURSE PRACTITIONER
Carolyn Davis Rutherford 3602 W Cumberland Ave, Middlesboro, KY 40965 NURSE PRACTITIONER
Aimee Brock 123 N 19th St, Middlesboro, KY 40965 NURSE PRACTITIONER
Samuel Bayless 2315 Cumberland Ave, Middlesboro, KY 40965 NURSE PRACTITIONER
Olivia Goad 3600 Cumberland Ave, Middlesboro, KY 40965 NURSE PRACTITIONER
Karen Mcdaniel 3004 W Cumberland Ave, Middlesboro, KY 40965 NURSE PRACTITIONER
Ashley Fultz 2010 Cumberland Ave, Middlesboro, KY 40965 NURSE PRACTITIONER

Zip 40965 · Medicare Physician

Name Address Specialty
Timothy Gardner 123 N 19th St, Middlesboro, KY 40965 PODIATRY
Meredith Eades 3600 Cumberland Ave, Middlesboro, KY 40965 CERTIFIED NURSE MIDWIFE
Nitinkumar Patel 3004 Cumberland Ave, Middlesboro, KY 40965 INTERNAL MEDICINE
Pablo Lopez 3600 Cumberland Ave, Middlesboro, KY 40965 CARDIOVASCULAR DISEASE (CARDIOLOGY)
Todd Mcgeorge 1431 E Cumberland Ave, Middlesboro, KY 40965 OPTOMETRY
Brenda Carey 123 N 19th St, Middlesboro, KY 40965 NURSE PRACTITIONER
Mohamad Alnahhas 3602 W Cumberland Ave, Middlesboro, KY 40965 FAMILY PRACTICE
Furrukh Jabbar 3600 Cumberland Ave, Middlesboro, KY 40965 GENERAL SURGERY
Albert Holmes 473 N 12th St, Middlesboro, KY 40965 OPHTHALMOLOGY
Kimberly Taylor 1313 Cumberland Ave, Middlesboro, KY 40965 CHIROPRACTIC
Samuel Bailey 3600 Cumberland Ave, Middlesboro, KY 40965 HEMATOLOGY/ONCOLOGY
James Taylor 2403 Cumberland Ave, Middlesboro, KY 40965 CHIROPRACTIC
Sean Owens 3600 Cumberland Ave, Middlesboro, KY 40965 DIAGNOSTIC RADIOLOGY
Firas Koura 3600 Cumberland Ave, Middlesboro, KY 40965 PULMONARY DISEASE
Joseph Slusher 3600 Cumberland Ave, Middlesboro, KY 40965 DIAGNOSTIC RADIOLOGY
Amy Goodin 3004 Cumberland Ave, Middlesboro, KY 40965 NURSE PRACTITIONER
Ronald Dubin 705 N 12th St, Middlesboro, KY 40965 ORTHOPEDIC SURGERY
Neil Barry 3004 Cumberland Ave, Middlesboro, KY 40965 INTERNAL MEDICINE
Marcina Bailey 123 N 19th St, Middlesboro, KY 40965 NURSE PRACTITIONER
Richard Lee 3600 W Cumberland Ave, Middlesboro, KY 40965 HEMATOLOGY/ONCOLOGY