Individual
MR. JEFFREY SCOTT ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1215 N BEAVER ST, FLAGSTAFF, AZ 86001-3120
(928) 773-2200
(928) 773-2300
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
279848
AZ
363L00000X
Nurse Practitioner
Primary
279848
AZ
Other
Enumeration date
08/23/2022
Last updated
08/21/2023
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