Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ethan Roback, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1891447801

Ethan Roback, MD is a Student in an Organized Health Care Education/Training Program in Columbus, Georgia. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2122 Manchester Expy
Columbus, GA 31904-6878
Phone: (706) 596-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1891447801
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 20, 2022
Last updated in NPPESApril 12, 2026
Certification dateApril 12, 2026
Mailing address2122 Manchester Expy, Columbus, GA 31904-6878

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