Basic Information
Provider Information
NPI: 1326015207
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROLLE
FirstName: WILLIAM
MiddleName: A
NamePrefix: DR.
NameSuffix: JR.
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3399 TRINDLE RD
Address2:  
City: CAMP HILL
State: PA
PostalCode: 170114407
CountryCode: US
TelephoneNumber: 7177615530
FaxNumber: 7177377197
Practice Location
Address1: 3399 TRINDLE RD
Address2:  
City: CAMP HILL
State: PA
PostalCode: 170114407
CountryCode: US
TelephoneNumber: 7177615530
FaxNumber: 7177377197
Other Information
ProviderEnumerationDate: 03/01/2006
LastUpdateDate: 12/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2081P2900XMD047520LPAN Allopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
208100000XMD047520LPAY Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 

No ID Information.


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