Roth, Karla Jean

Roth, Karla Jean is an individual health care provider with primary practice located at 3860 Monroe Rd , De Pere WI 54115-8399. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Roth, Karla Jean can be contacted via phone (920) 496-4700.

Contact Information

Primary practice address
3860 Monroe Rd De Pere WI 54115-8399
Fax: (920) 431-1967
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 37108 Wisconsin

Profile Details

NPI number 1508890971
LBN Legal business name Roth, Karla Jean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Sep 24th, 2019 - about 5 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 1508890971 NPPES
Wisconsin MEDICAID 32183200

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