Jeffrey Ira Roth
Otolaryngologist (ENT Doctor) Pediatric Otolaryngology
4385 Johns Creek Pkwy Ste 250
Suwanee
, Georgia 30024-6048
Jeffrey Ira Roth
Otolaryngologist (ENT Doctor) Pediatric Otolaryngology
4385 Johns Creek Pkwy Ste 250
Suwanee
, Georgia 30024-6048
(678) 992-2540
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About
Features
Specialties
- Otolaryngologist (ENT Doctor)
- Pediatric Otolaryngology
Languages spoken
- English
Location
First Address
- Jeffrey Ira Roth
- 4385 Johns Creek Pkwy Ste 250
- Suwanee, GA
- Zip : 30024-6048
- Fax : (678) 992-2540
- Phone : (770) 623-1608
Second Address
- Jeffrey Ira Roth
- 4385 Johns Creek Pkwy Ste 250
- Suwanee, GA
- Zip : 30024-6048
- Fax : (678) 992-2540
- Phone : (770) 623-1608
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 041654 | GA |
| N | 207YP0228X | Pediatric Otolaryngology | 041654 | GA |
National Provider Identifier
| NPI | 1417945320 |
|---|---|
| Provider Name | Jeffrey Ira Roth |
| First Address | Suwanee, GA 30024-6048 |
| Second Address | Suwanee, GA 30024-6048 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/10/2005 |
| Last Update Date | 18/12/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000714381J | (05) | GA |
| 000714381M | (05) | GA |
| G26918 | (02) |
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.