Individual
DR. JERRY M ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
501 STREET RD STE 101, SOUTHAMPTON, PA 18966-3796
(215) 357-5780
(215) 364-8983
Mailing address
501 STREET RD, SOUTHAMPTON, PA 18966-3746
(215) 357-5780
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD030012E
PA
Other
Enumeration date
06/23/2005
Last updated
02/14/2018
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