Earl Eugene Roth Jr., MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

14021 Issued in AZ

Practice address

5891 W Eugie Ave
Glendale, AZ 85304-1252

Phone

(602) 588-6703

NPI assigned

Jan 26, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1124098579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 N BLACK CANYON HWY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850294757",
            "telephone_number": "602-371-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5891 W EUGIE AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041252",
            "telephone_number": "602-588-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "EARL",
        "middle_name": "EUGENE",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "14021",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AZ",
            "license": "14021",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "14021",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "448424",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alfred C Rossum, MD
• Carla Jean Rotering, MD
• Barbara J. Roth
• Brandon Ian Roth, M.D.
• Bruce Alan Roth, D.O.
• Daniela Rothenberg
• Samantha Rothman
• Charles Rounds, PAC
• Dominike Rounds
• Omhrie Rouzan

• All providers in Glendale, AZ
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.