# HAROLD F. ROTH, D.O.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538677026
- **Authorized official:** DR. HAROLD FRANKLIN ROTH DO (PROVIDER)
- **Authorized official phone:** (517) 485-1789

## Contact information

- **Practice address:** 1627 LAKE LANSING RD STE 200, LANSING, MI 48912-3788
- **Practice address phone:** (517) 485-1789
- **Practice address fax:** (517) 485-2357
- **Mailing address:** 1627 LAKE LANSING RD STE 200, LANSING, MI 48912-3788
- **Mailing address phone:** (517) 485-1789
- **Mailing address fax:** (517) 485-2357

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 5101007838 | MI | Yes |
| 363LF0000X | Family Nurse Practitioner | 4704259692 | MI | — |

## Other

- **Enumeration date:** 01/18/2018
- **Last updated:** 01/18/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1023005659 | — | MI |