Provider Demographics
NPI:1669656526
Name:ROTELLA, JOSEPH A (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:ROTELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10117 N 92ND ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4555
Mailing Address - Country:US
Mailing Address - Phone:480-614-5808
Mailing Address - Fax:480-614-5809
Practice Address - Street 1:10117 N 92ND ST STE 101
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4555
Practice Address - Country:US
Practice Address - Phone:480-614-5808
Practice Address - Fax:480-614-5809
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ40913207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine