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NPI Code Detail

MEDICARE: ZOE JAMISON ROTH DO

MEDICARE: ZOE JAMISON ROTH DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207QS0010XSports Medicine (Family Medicine) PhysicianDO-55677IA

General Provider Information

NPI Number : 1346935756
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZOE JAMISON ROTH DO
Provider Business Mailing Address
First Line : 200 HAWKINS DR
Second Line :
City : IOWA CITY
State : IA
Zip : 52242-1009
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1102 S PARK ST
Second Line :
City : MADISON
State : WI
Zip : 53715-1708
Country : US
Telephone Number : 608-263-3111
Fax Number : 608-263-6663
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2023
Last Update Date : 05/13/2026

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Directions to “ ZOE JAMISON ROTH DO” Practice Location

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