Organization
JOHN D ROSCOE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN DOMINIC ROSCOE JR. M.D. (PRESIDENT)
(219) 465-7277
Entity
Organization
Contact information
Practice address
2000 ROOSEVELT RD, SUITE 203, VALPARAISO, IN 46383-2800
(219) 465-7277
(219) 464-2957
Mailing address
2000 ROOSEVELT RD, SUITE 203, VALPARAISO, IN 46383-2800
(219) 465-7277
(219) 464-2957
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01030427A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100208460A
—
IN
Enumeration date
11/15/2010
Last updated
11/15/2010
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