Individual
MR. JASON DAVID ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
8450 NORTHWEST BLVD, INDIANAPOLIS, IN 46278-1381
(317) 802-2000
(317) 802-2170
Mailing address
8450 NORTHWEST BLVD, INDIANAPOLIS, IN 46278-1381
(317) 802-2000
(317) 802-2170
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000474A
IN
Other
Enumeration date
05/10/2006
Last updated
05/16/2024
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