Provider Demographics
NPI:1831327840
Name:ROESCH, JUSTIN JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:JAMES
Last Name:ROESCH
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 1:2021 BATTLECREEK DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-5120
Mailing Address - Country:US
Mailing Address - Phone:970-818-5725
Mailing Address - Fax:
Practice Address - Street 1:2021 BATTLECREEK DR UNIT A
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-5120
Practice Address - Country:US
Practice Address - Phone:970-818-5725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD75573207R00000X
NMMD2014-0547207R00000X
AZR71674207R00000X
CODR.0063333207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine