Organization
JONATHAN B ROTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN B ROTH MD (MD)
(405) 348-6500
Entity
Organization
Contact information
Practice address
2000 E 15TH ST, 150A, EDMOND, OK 73013-6697
(405) 348-6500
(405) 348-6501
Mailing address
2000 E 15TH ST STE 150A, EDMOND, OK 73013-6679
(405) 348-6500
(405) 348-6501
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
26618
OK
Other
Enumeration date
03/01/2011
Last updated
03/01/2011
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