MEDICARE: DR. JOHN A ROTHSCHILD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	MD012782E	PA
2	207R00000X	Internal Medicine Physician	MD012782E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003903667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN A ROTHSCHILD MD

Provider Business Mailing Address
First Line	:	2623 LAKESIDE DR
Second Line	:
City	:	HARVEYS LAKE
State	:	PA
Zip	:	18618-3231
Country	:	US
Telephone Number	:	570-814-9007
Fax Number	:	877-991-6605

Provider Business Practice Location Address
First Line	:	2623 LAKESIDE DR
Second Line	:
City	:	HARVEYS LAKE
State	:	PA
Zip	:	18618-3231
Country	:	US
Telephone Number	:	570-814-9007
Fax Number	:	877-991-6605

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	08/24/2021

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