Provider Demographics
NPI:1598768392
Name:ROOTRING, JOHN (DPM)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:ROOTRING
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 933400
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0038
Mailing Address - Country:US
Mailing Address - Phone:513-984-1911
Mailing Address - Fax:513-984-1912
Practice Address - Street 1:8280 MONTGOMERY RD STE 103
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-6101
Practice Address - Country:US
Practice Address - Phone:513-984-1911
Practice Address - Fax:513-984-1912
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002400213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0724694Medicaid
OHCD5236OtherRAILROAD MEDICARE
OH480021690OtherRAILROAD MEDICARE
OH0459267Medicaid
OH480021690OtherRAILROAD MEDICARE
OHCD5236OtherRAILROAD MEDICARE
OH0459267Medicaid