Individual
MR. JARROD D ROUSSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA.-C
Contact information
Practice address
9700 N 91ST ST STE A115, SCOTTSDALE, AZ 85258-5036
(888) 803-3370
(415) 779-8032
Mailing address
487 MEADOW LAKE DR, FREEPORT, FL 32439-2356
(850) 400-4245
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110-010484
VA
363A00000X
Physician Assistant
085.010957
IL
363A00000X
Physician Assistant
Primary
10629
AZ
363A00000X
Physician Assistant
PA9110302
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3720420
MEDICARE
TN
01
—
KN153
MEDICARE
FL
Enumeration date
02/21/2006
Last updated
07/31/2025
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