Individual
DR. JOSEPH C. ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
11320 S. M 43 HWY, DELTON, MI 49046-9259
(269) 623-5121
Mailing address
11320 S. M 43 HWY., DELTON, MI 49046-9259
(269) 623-5521
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101008288
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124120597
NPI
—
01
—
371573958
TAX ID
MI
Enumeration date
09/05/2006
Last updated
11/19/2011
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