Provider Demographics
NPI:1649257411
Name:ROHAN, JOHN WILLIAM (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:WILLIAM
Last Name:ROHAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ANESTHESIOLOGOY CONSULTANTS ENTERPRISES, PLLC
Mailing Address - Street 2:P.O. BOX 23354
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40523-3354
Mailing Address - Country:US
Mailing Address - Phone:859-268-1030
Mailing Address - Fax:859-259-4120
Practice Address - Street 1:ONE AUDUBON PLAZA DRIVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217
Practice Address - Country:US
Practice Address - Phone:859-268-1030
Practice Address - Fax:859-269-4120
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY02488207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64082753Medicaid
KYA15719Medicare UPIN
KY0783045Medicare PIN