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Organization

ROBERT ROTH MD A PROFESSIONAL

Active
Other names
BOX CANYON PRIMARY CARE
Organization subpart
No

Provider details

NPI number
Authorized official
ASHLEY NUSS CPC (BILLER/CODER)
(702) 363-5575
Entity
Organization

Contact information

Practice address
2647 BOX CANYON DR, LAS VEGAS, NV 89128-0450
(702) 363-5575
(702) 646-1727
Mailing address
2647 BOX CANYON DR, LAS VEGAS, NV 89128-0450
(702) 363-5575
(702) 646-1727

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
8797
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
V101524
MEDICARE GROUP #
NV
Enumeration date
02/27/2008
Last updated
08/31/2021
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