Provider Demographics
NPI:1346238599
Name:ROLLINS, JAMES ROY JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROY
Last Name:ROLLINS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-0936
Mailing Address - Country:US
Mailing Address - Phone:606-330-7840
Mailing Address - Fax:606-330-7825
Practice Address - Street 1:624 MAYSVILLE RD
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-9767
Practice Address - Country:US
Practice Address - Phone:859-497-4144
Practice Address - Fax:859-498-4137
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34560207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
2096059OtherUNITED HEALTHCARE
KY64029895Medicaid
KY000000280122OtherANTHEM
G93824Medicare UPIN
KY64029895Medicaid