Organization
JEFFREY A ROTHER, MD, PC
Active
Organization
JEFFREY A ROTHER, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY A ROTHER MD (OWNER)
(580) 224-2900
Entity
Organization
Contact information
Practice address
1221 G ST NW, ARDMORE, OK 73401-1812
(580) 224-2900
(580) 224-0009
Mailing address
1221 G ST NW, ARDMORE, OK 73401-1812
(580) 224-2900
(580) 224-0009
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
17679
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17679
OK LICENSE #
OK
01
—
1811951999
TAX ID #
OK
01
—
442605098-002
BCBS 12 DIGIT #
OK
Enumeration date
08/29/2006
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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