Provider Demographics
NPI:1215954037
Name:GELPERIN, ROGER LEWIS (DO)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:LEWIS
Last Name:GELPERIN
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 1:1382 HUTCHERSON LN
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-6999
Mailing Address - Country:US
Mailing Address - Phone:915-491-4575
Mailing Address - Fax:270-735-9311
Practice Address - Street 1:1382 HUTCHERSON LN
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-6999
Practice Address - Country:US
Practice Address - Phone:915-491-4575
Practice Address - Fax:270-735-9311
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY03736207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine