Healthcare Provider Details
I. General information
NPI: 1265419584
Provider Name (Legal Business Name): JAMES H. ROTHSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/28/2005
Last Update Date: 05/03/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5000 KY ROUTE 321
PRESTONSBURG KY
41653-9113
US
IV. Provider business mailing address
7610 CARROLL AVE STE 100
TAKOMA PARK MD
20912-6311
US
V. Phone/Fax
- Phone: 606-886-1316
- Fax:
- Phone: 301-891-2500
- Fax: 301-448-1679
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | 12009 |
| License Number State | NH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: