Provider Demographics
NPI:1902815814
Name:FLEISCHMAN, ROGER ALAN (MD)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:ALAN
Last Name:FLEISCHMAN
Suffix:
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:B412 VA HOSPITAL COOPER DRIVE
Mailing Address - Street 2:INTERNAL MEDICINE
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-2142
Mailing Address - Country:US
Mailing Address - Phone:859-257-6006
Mailing Address - Fax:859-257-6002
Practice Address - Street 1:800 ROSE STREET CC180A ROACH BLDG.
Practice Address - Street 2:UK HEMATOLOGY CLINIC
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0093
Practice Address - Country:US
Practice Address - Phone:859-257-6006
Practice Address - Fax:859-257-6002
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY29871207R00000X, 207RH0003X, 207RX0202X, 207ZH0000X, 207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64298714Medicaid
KY64298714Medicaid
KY00258129Medicare PIN