Individual
DR. DONNA E ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3475 RICHMOND RD, STE 200, LEXINGTON, KY 40509-2500
(859) 296-4400
(859) 296-4300
Mailing address
3475 RICHMOND RD, STE 200, LEXINGTON, KY 40509-2500
(859) 296-4400
(859) 296-4300
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25432
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000007043
CHA PROVIDER NUMBER
KY
01
—
000000317657
ANTHEM PROVIDER NUMBER
KY
01
—
0007542016
AETNA PROVIDER NUMBER
KY
Enumeration date
07/01/2005
Last updated
05/05/2008
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