Roth, Robert Eric

Roth, Robert Eric is an sole proprietor health care provider with primary practice located at 2333 Knob Creek Rd Suite 11, Johnson City TN 37604-2007. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Roth, Robert Eric can be contacted via phone (423) 952-0500.

Contact Information

Primary practice address
2333 Knob Creek Rd Suite 11 Johnson City TN 37604-2007
Phone: (423) 952-0500
Fax: (423) 952-0005
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2177 Tennessee

Profile Details

NPI number 1992792519
LBN Legal business name Roth, Robert Eric
Credentials PSYD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 29th, 2005
Last updated Jul 8th, 2007 - about 19 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 1992792519 NPPES
Tennessee Other 4076590 BCBS - MEDICAL
Tennessee MEDICAID 3689027 BCBS - MEDICAL
Tennessee Other 4037912 BCBS - MEDICAL
Tennessee Other TN0101 BCBS - MEDICAL

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