Roe, Jonathan D

Roe, Jonathan D is an individual health care provider with primary practice located at 3400 Deerfield Dr , Janesville WI 53546-3557. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Roe, Jonathan D can be contacted via phone (608) 314-3600.

Contact Information

Primary practice address
3400 Deerfield Dr Janesville WI 53546-3557
Fax: (608) 314-3601
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35916-20 Wisconsin

Profile Details

NPI number 1366507709
LBN Legal business name Roe, Jonathan D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 26th, 2006
Last updated Apr 16th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366507709 NPPES
Wisconsin MEDICAID 32061100
Wisconsin MEDICAID 347845572 1
Wisconsin Other ROEJON

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