Individual
JOHN D ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4133 MEDICAL CENTER DR, BROAD TOP, PA 16621-9001
(814) 635-2916
(814) 635-2918
Mailing address
4133 MEDICAL CENTER DR, BROAD TOP, PA 16621-9001
(814) 635-2916
(814) 635-2918
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD047424L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000742911
HIGHMARK BCBS
PA
05
—
007017627-0002
—
PA
05
—
007017627-0004
—
PA
05
—
007017627-0005
—
PA
05
—
007017627-0006
—
PA
05
—
007017627-0007
—
PA
05
—
007017627-0009
—
PA
05
—
007017627-0010
—
PA
01
—
206707
UPMC
PA
01
—
30707170
AMERIHEALTH CARITAS
PA
01
—
30802890
AMERIHEALTH CARITAS
PA
01
—
30802912
AMERIHEALTH CARITAS
PA
01
—
30802932
AMERIHEALTH CARITAS
PA
01
—
30803027
AMERIHEALTH CARITAS
PA
01
—
7715310
AETNA / COVENTRY
PA
01
—
P02157142
RAILROAD MEDICARE
PA
Enumeration date
07/05/2005
Last updated
06/06/2024
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