Provider Demographics
NPI:1902854920
Name:ROTHE, THOMAS C (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:C
Last Name:ROTHE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5055 E BROADWAY BLVD
Mailing Address - Street 2:STE A-100
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-3640
Mailing Address - Country:US
Mailing Address - Phone:520-327-0460
Mailing Address - Fax:520-795-0225
Practice Address - Street 1:6130 N LA CHOLLA BLVD
Practice Address - Street 2:SUITE 100 LA CHOLLA FAMILY PRACTICE
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3557
Practice Address - Country:US
Practice Address - Phone:520-742-4159
Practice Address - Fax:520-742-3493
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2010-02-26
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Provider Licenses
StateLicense IDTaxonomies
AZ10702207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D37551Medicare UPIN