Individual
DR. HAROLD FRANKLIN ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1627 LAKE LANSING RD, SUITE 200, LANSING, MI 48912-3788
(517) 485-1789
(517) 485-2357
Mailing address
1627 LAKE LANSING RD, SUITE 200, LANSING, MI 48912-3788
(517) 485-1789
(517) 485-2357
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
5101007838
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0153310524
BCBSM
MI
05
—
112117791
—
MI
01
—
200000005857
PHP OF MID-MICHIGAN
MI
01
—
201488
MCLAREN HEALTH PLAN
MI
01
—
38-2402492
FEDERAL EMPLOYER ID NUMBE
—
Enumeration date
09/29/2005
Last updated
01/01/2018
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