Provider Demographics
NPI:1609214246
Name:ROETTGES, PAUL SEBASTIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:SEBASTIAN
Last Name:ROETTGES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6800 SOUTHPOINT PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-8203
Mailing Address - Country:US
Mailing Address - Phone:904-634-0640
Mailing Address - Fax:904-634-0203
Practice Address - Street 1:216 SOUTHPARK CIR E STE 216
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5135
Practice Address - Country:US
Practice Address - Phone:904-634-0640
Practice Address - Fax:904-634-0202
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZR73929207X00000X
FLME134760207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery