Healthcare Provider Details

I. General information

NPI: 1386228666
Provider Name (Legal Business Name): JAMES CHRISTOPHER ROUSHER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2021
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E STATE ROUTE 14 STE 201
COLUMBIANA OH
44408-8490
US

IV. Provider business mailing address

100 DEBARTOLO PL STE 200
YOUNGSTOWN OH
44512-6095
US

V. Phone/Fax

Practice location:
  • Phone: 234-287-6614
  • Fax: 234-338-9451
Mailing address:
  • Phone: 330-729-8146
  • Fax: 330-965-5229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number59.000887
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: