Provider Demographics
NPI:1184759169
Name:ROTE, JOAN MURRAY (MD)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:MURRAY
Last Name:ROTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3190 STATE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8497
Mailing Address - Country:US
Mailing Address - Phone:541-734-7733
Mailing Address - Fax:541-734-7744
Practice Address - Street 1:3190 STATE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8497
Practice Address - Country:US
Practice Address - Phone:541-734-7733
Practice Address - Fax:541-734-7744
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD15974207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR072165Medicaid
ORC02554Medicare UPIN
OR072165Medicaid