Organization
JEFFREY A ROTHER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY A ROTHER M.D. (CHIEF EXECUTIVE OFFICER)
(580) 224-2900
Entity
Organization
Contact information
Practice address
1221 G ST NW, ARDMORE, OK 73401-1812
(580) 224-2900
(580) 224-0009
Mailing address
1221 G ST NW, ARDMORE, OK 73401-1812
(580) 224-2900
(580) 224-0009
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17679
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100101430A
—
OK
Enumeration date
02/08/2007
Last updated
11/19/2007
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