Terry R Roth Md Pc

LBN: Terry R Roth Md Pc
Terry R Roth Md Pc is an health care organization with primary practice located at 4920 E State St , Rockford IL 61108-2272. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Terry R Roth Md Pc can be contacted via phone (815) 226-1906, or through Roth, Terry R via phone (815) 226-1906.

Contact Information

Primary practice address
4920 E State St Rockford IL 61108-2272
Phone: (815) 226-1906
Fax: (815) 226-8474
Website:
Map and Directions
Authorized official contact:
Name: Roth, Terry R Doctor of Medicine (MD)
Phone: (815) 226-1906

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1265601579
LBN Legal business name Terry R Roth Md Pc
DBA Doing business as
Authorized official Roth, Terry R Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 21st, 2008
Last updated Jun 25th, 2015 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265601579 NPPES
Illinois Other 10132303 BCBS
Illinois Other 629800 BCBS

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