Provider Demographics
NPI:1457333460
Name:CHENG, ROLANDO L (MD)
Entity Type:Individual
Prefix:DR
First Name:ROLANDO
Middle Name:L
Last Name:CHENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2801 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:POCAHONTAS
Mailing Address - State:AR
Mailing Address - Zip Code:72455-9436
Mailing Address - Country:US
Mailing Address - Phone:870-892-6265
Mailing Address - Fax:870-892-6271
Practice Address - Street 1:310 CAMP RD
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:AR
Practice Address - Zip Code:72455-9131
Practice Address - Country:US
Practice Address - Phone:859-235-0960
Practice Address - Fax:859-235-3690
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE6308207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64213267Medicaid
KY90012188OtherMEDICAID DME
KY14958526000OtherOHIO BUREAU OF WORKERS CO
0228330001OtherMEDICARE DME
KY611009038OtherTAX ID
KY0228330001OtherDMERC
KY1061251OtherPASSPORT
KY000000047713OtherANTHEM
KY65901761Medicaid
KY90012188OtherMEDICAID DME
KY1061251OtherPASSPORT
KY000000047713OtherANTHEM