Individual
DR. JAMES M ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 CRESTVIEW PARK DR STE 2, DICKSON, TN 37055-2853
(615) 740-5233
(615) 740-5226
Mailing address
125 CRESTVIEW PARK DR, SUITE 2, DICKSON, TN 37055-2850
(615) 740-5233
(615) 740-5226
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
38445
TN
207YP0228X
Pediatric Otolaryngology Physician
38445
TN
207YS0123X
Facial Plastic Surgery Physician
38445
TN
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
38445
TN
207YX0901X
Otology & Neurotology Physician
38445
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007459536
AETNA
TN
05
—
3896879
—
TN
01
—
4089622
BLUE CROSS AND BLUE SHIEL
TN
01
—
7714168
CIGNA
TN
01
—
P00160344
MEDICARE RAILROAD
TN
Enumeration date
06/28/2005
Last updated
04/09/2018
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