Individual
DR. REED T ROTH
Active
Individual
DR. REED T ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4965T1835
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000301272
ANTHEM BC/BS
OH
01
—
03418
PARAMOUNT HEALTH CARE
OH
05
—
2151068
—
OH
01
—
360954
NATIONAL VISION ADMINISTR
OH
Enumeration date
05/24/2005
Last updated
05/09/2012
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