Roth, Randy
Roth, Randy is an individual health care provider with primary practice located at 2809 Denny Ave , Pascagoula MS 39581-5301. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Roth, Randy can be contacted via phone (228) 809-5510.Contact Information
Primary practice address
2809 Denny Ave
Pascagoula MS 39581-5301
Phone: (228) 809-5510
Fax: (228) 809-5519
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MS14779 | Mississippi |
Profile Details
| NPI number | 1013068212 |
|---|---|
| LBN Legal business name | Roth, Randy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 15th, 2007 |
| Last updated | Jun 29th, 2022 - about 4 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 | 1013068212 | NPPES |
| Alabama | MEDICAID | 009917145 | |
| Alabama | Other | 646000515E | |
| Alabama | Other | 60039090 | |
| Alabama | MEDICAID | RR00116679 |
Popular Providers
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Frye, Charles
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