Individual
DR. WILLIAM BRADLEY ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 W PINHOOK RD, SUITE 304, LAFAYETTE, LA 70503-2460
(337) 289-9155
(337) 289-9585
Mailing address
1000 W PINHOOK RD, SUITE 304, LAFAYETTE, LA 70503-2460
(337) 289-9155
(337) 289-9585
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
14924R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1156191
—
LA
Enumeration date
07/06/2005
Last updated
02/10/2011
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