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General NPI Number Information
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NPI Number | 1720421290
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Entity Type | Individual
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Provider Name | JOSHUA K ROUTH M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/15/2013
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Last Update Date | 06/17/2022
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Provider Practice Location Address
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Address Line | 1 N 1ST ST STE 700
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City | PHOENIX
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State | AZ
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Zip | 85004-2364
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Country | US
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Telephone | 602-481-9650
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Fax | 602-610-4757
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Provider Business Mailing Address
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Address Line | 1 N 1ST ST STE 700
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City | PHOENIX
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State | AZ
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Zip | 85004-2364
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Country | US
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Telephone | 602-649-4498
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Fax | 602-610-4757
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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 | 207ZP0007X
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Taxonomy Name | Molecular Genetic Pathology (Pathology) Physician
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License Number | 56886
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | MD2017-0765
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License Number State | NM
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