Individual
JONATHAN D ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 DEERFIELD DR, JANESVILLE, WI 53546-3557
(608) 314-3600
(608) 314-3601
Mailing address
3400 DEERFIELD DR, JANESVILLE, WI 53546-3557
(608) 314-3600
(608) 314-3601
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35916-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32061100
—
WI
05
—
347845572 1
—
IL
01
—
ROEJON
MERCYCARE INSURANCE
WI
Enumeration date
12/26/2006
Last updated
04/16/2015
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