Roth, Justin Stephan

Roth, Justin Stephan is an individual health care provider with primary practice located at 3399 E Louise Dr Ste 200 , Meridian ID 83642-5212. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Orthopaedic Surgery, which is considered as his primary health care specialty. Roth, Justin Stephan can be contacted via phone (208) 706-2663.

Contact Information

Primary practice address
3399 E Louise Dr Ste 200 Meridian ID 83642-5212
Phone: (208) 706-2663
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Orthopaedic Surgery 207XP3100X O-1847 Idaho
Allopathic & Osteopathic Physicians / Pediatric Orthopaedic Surgery 207XP3100X 187405 Oregon

Profile Details

NPI number 1306109954
LBN Legal business name Roth, Justin Stephan
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2012
Last updated Jul 28th, 2023 - about last year

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 1306109954 NPPES
Oregon MEDICAID 500746847
Oregon Other 187405

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