Healthcare Provider Details

I. General information

NPI: 1487098000
Provider Name (Legal Business Name): ALEXANDER CRAIG ROTHY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2013
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 PROFESSIONAL PARK DR STE 21
JOHNSON CITY TN
37604-6529
US

IV. Provider business mailing address

3 PROFESSIONAL PARK DR STE 21
JOHNSON CITY TN
37604-6529
US

V. Phone/Fax

Practice location:
  • Phone: 423-434-6300
  • Fax: 423-434-6312
Mailing address:
  • Phone: 423-434-6300
  • Fax: 423-434-6312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number66808
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: