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General NPI Number Information
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NPI Number | 1669408258
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Entity Type | Organization
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Legal Business Name | REINHARD E. ROTT, MD, FACS, LLC
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 10/30/2007
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Provider Practice Location Address
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Address Line | 1715 W NORTHERN AVE
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City | PHOENIX
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State | AZ
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Zip | 85021-5472
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Country | US
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Telephone | 602-395-0718
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Fax | 602-277-8146
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Provider Business Mailing Address
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Address Line | PO BOX 39179
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City | PHOENIX
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State | AZ
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Zip | 85069-9179
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Country | US
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Telephone | 602-395-0718
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Fax | 602-277-8146
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Authorized Official
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Title or Position | OWNER
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Name | REINHARD ROTT
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Credential | MD
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Telephone | 602-395-0718
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 30464
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License Number State | AZ
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