Joseph C. Roth, DO
Individual provider Active NPI Family Medicine Physician · Delton, MI
NPI 1124120597 · NPPES record last updated Nov 19, 2011
Key facts
- NPI
- 1124120597
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 5101008288 (MI)
- Practice address
- 11320 S. M 43 Hwy
Delton, MI 49046-9259 - Phone
- (269) 623-5121
- NPI assigned
- Sep 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pennock Hospital | Family Medicine | Past | Accepting new patients |
| The Doctors Group, P.C. | Family Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101008288 | MI | Yes |
Addresses
Primary practice location
11320 S. M 43 Hwy
Delton, MI 49046-9259
Mailing address
11320 S. M 43 Hwy.
Delton, MI 49046-9259
Phone (269) 623-5521
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124120597 | Other | NPI | |
| 371573958 | Other | MI | TAX ID |
Other providers in Delton, MI
- Mary A Martin
- Deborah Lynn Pace
- Pennock Hospital
- Pennock Hospital Board of Trustees
- Reliant Home Care, LLC
- Robert Secor
- Jennifer Lynn Sinkler
- Patricia Catherine Werme
All providers in Delton, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 19, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.