Dr. Justin Stephan Roth
Pediatric Orthopaedic Surgeon
2200 Ne Neff Rd Ste 200
Bend
, Oregon 97701-4281
Dr. Justin Stephan Roth
Pediatric Orthopaedic Surgeon
2200 Ne Neff Rd Ste 200
Bend
, Oregon 97701-4281
(415) 382-3344
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About
Features
Specialties
- Pediatric Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Dr. Justin Stephan Roth
- 2200 Ne Neff Rd Ste 200
- Bend, OR
- Zip : 97701-4281
- Phone : (415) 382-3344
Second Address
- Dr. Justin Stephan Roth
- 2200 Ne Neff Rd Ste 200
- Bend, OR
- Zip : 97701-4281
- Phone : (541) 382-3344
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 187405 | OR |
National Provider Identifier
| NPI | 1306109954 |
|---|---|
| Provider Name | Dr. Justin Stephan Roth |
| First Address | Bend, OR 97701-4281 |
| Second Address | Bend, OR 97701-4281 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/06/2012 |
| Last Update Date | 26/04/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 187405 | OREGON MEDICAL BOARD (01) | OR |
| 500746847 | (05) | OR |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.