Provider Demographics
NPI:1225898430
Name:ROTH, JULIA (DO)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:ROTH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 WEYHILL CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-3817
Mailing Address - Country:US
Mailing Address - Phone:770-289-9953
Mailing Address - Fax:
Practice Address - Street 1:665 DULUTH HWY STE 501
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-8709
Practice Address - Country:US
Practice Address - Phone:678-312-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program