Individual
JOHN D ROOF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1030 5TH AVE SE, SUITE 1400, CEDAR RAPIDS, IA 52403-2464
(319) 363-8121
(319) 365-1396
Mailing address
1030 5TH AVE SE, SUITE 1400, CEDAR RAPIDS, IA 52403-2464
(319) 363-8121
(319) 365-1396
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25515
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080078854
RR MEDICARE
IA
05
—
1306825922
—
IA
05
—
2032052
—
IA
05
—
3032052
—
IA
05
—
4032052
—
IA
01
—
970003141
RR MEDICARE
IA
Enumeration date
01/12/2006
Last updated
05/17/2012
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