Roth, Earl Eugene
Roth, Earl Eugene is an individual health care provider with primary practice located at 5891 W Eugie Ave , Glendale AZ 85304-1252. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Roth, Earl Eugene can be contacted via phone (602) 588-6703.Contact Information
Primary practice address
5891 W Eugie Ave
Glendale AZ 85304-1252
Phone: (602) 588-6703
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 14021 | Arizona |
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 14021 | Arizona |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 14021 | Arizona |
Profile Details
| NPI number | 1124098579 |
|---|---|
| LBN Legal business name | Roth, Earl Eugene |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2006 |
| Last updated | Oct 11th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124098579 | NPPES |
| Arizona | MEDICAID | 448424 |
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