Individual
JASON T ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11600 W 2ND PL, ST,. ANTHONY HOSPITAL, EMERGENCY DEPT., LAKEWOOD, CO 80228-1527
(720) 321-4161
(720) 321-4165
Mailing address
PO BOX 5788, DENVER, CO 80217-5788
(303) 202-1280
(303) 202-1281
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
41184
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122701700
—
WY
05
—
143861
—
AZ
05
—
200384260A
—
KS
05
—
77005384
—
CO
05
—
78789770
—
NM
01
—
P00299240
RR MEDICARE
CO
05
—
Z3279
—
UT
Enumeration date
02/13/2006
Last updated
08/14/2013
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