Individual
MR. JOHN R ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPAS, PA-C
Contact information
Practice address
920 COUNTRY CLUB RD STE 140A, EUGENE, OR 97401-6024
(503) 362-8385
(503) 362-8435
Mailing address
PO BOX 741825, LOS ANGELES, CA 90074-1825
(503) 362-8385
(503) 362-8435
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01418
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/19/2007
Last updated
03/08/2022
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