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General NPI Number Information
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NPI Number | 1326606351
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Entity Type | Individual
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Provider Name | ERICA CRANSTON ROTH
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Gender | Female
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Dates
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Enumeration Date | 06/04/2019
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 80 JESSE HILL JR DR SE
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City | ATLANTA
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State | GA
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Zip | 30303-3031
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Country | US
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Telephone | 404-616-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 313 OAKLAND ST
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City | DECATUR
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State | GA
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Zip | 30030-2430
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MT218164
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 98528
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License Number State | GA
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