Individual
DR. JOHN G ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
177 BURT RD, LEXINGTON, KY 40503-2410
(859) 276-1511
(859) 276-3373
Mailing address
177 BURT RD, LEXINGTON, KY 40503-2410
(859) 276-1511
(859) 276-3373
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
28647
KY
207NS0135X
Procedural Dermatology Physician
Primary
28647
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64286479
—
KY
Enumeration date
02/15/2006
Last updated
01/06/2009
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