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Organization

HAROLD F. ROTH, D.O.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HAROLD FRANKLIN ROTH DO (PROVIDER)
(517) 485-1789
Entity
Organization

Contact information

Practice address
1627 LAKE LANSING RD STE 200, LANSING, MI 48912-3788
(517) 485-1789
(517) 485-2357
Mailing address
1627 LAKE LANSING RD STE 200, LANSING, MI 48912-3788
(517) 485-1789
(517) 485-2357

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
5101007838
MI
363LF0000X
Family Nurse Practitioner
4704259692
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023005659
MI
Enumeration date
01/18/2018
Last updated
01/18/2018
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