DR. EARL J ROTH (NPI# 1205999646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205999646 |
| Entity Type | Individual |
| Full Name | DR. EARL J ROTH |
| Credential | DC |
| Practice Address |
612 Century Ave Antigo WI 54409 |
| Mailing Address |
612 Century Ave Antigo WI 54409-2447 |
| Practice Telephone | 7156235300 |
| Mailing Telephone | 7156235300 |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2019-04-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 3510 | WI | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 38937600 | 05 | |
| WI | RAILROAD MEDICARE | 350055781 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5829 Birch Ln, Rhinelander, WI 545018986 | 7153651200 | 7153651202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124098579 | Earl Eugene Roth Jr. | Emergency Medicine | 5891 W Eugie Ave, Glendale, AZ 85304-1252 | 2006-01-26 |
| Street Address |
612 CENTURY AVE |
| City | ANTIGO |
| State | WI |
| Zip Code | 54409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710306550 | In Balance Chiropractic LLC | Chiropractor | 612 Century Ave, None, Antigo, WI 54409-2447 | 2014-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454036 | Jason Peter Cueny | Pharmacist | 200 E Highway 64, Antigo, WI 54409 | 2020-10-15 |
| 1770194524 | Christpher George Rowe | Technician | 825 Clermont S Apt 7, Antigo, WI 54409 | 2020-08-14 |
| 1033753512 | Joseph Gerger | Technician | 711 Badger Ave, Antigo, WI 54409 | 2019-10-29 |
| 1225368780 | Integrated Pain Solutions LLC | Clinic/Center | 2327 Neva Road, Antigo, WI 54409 | 2010-01-06 |
| 1558525212 | Jessica E Rosenberg | Social Worker | 310 South Superior Street, Antigo, WI 54409 | 2008-07-11 |
| 1053433292 | Raymond J Portman | Dentist | 705 Fifth Ave, Antigo, WI 54409 | 2007-04-06 |
| 1699801316 | Rick L Perkins | Obstetrics & Gynecology | Aspirus General Clinic, 110 East 5th Avenue, Antigo, WI 54409 | 2007-02-26 |
| 1811061187 | Rosanne Schermetzler | Occupational Therapist | 720 Ackley Street, Antigo, WI 54409 | 2006-11-20 |
| 1912084070 | Antigo Total Therapy & Sports Rehab Center Inc | Physical Therapist | 720 Askley Street, Antigo, WI 54409 | 2006-11-01 |
| 1114000213 | Nicole Suzanne Debroux | Chiropractor | 2006 Progress Blvd, Antigo, WI 54409 | 2006-10-23 |
| Find all providers in zip 54409 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679606396 | Margaret Ann Rosauer-johnson | Chiropractor | 510 Superior St, Antigo, WI 54409-2043 | 2007-03-13 |
| 1225179112 | Andrew Cary Krueger | Chiropractor | 436 Superior St, Antigo, WI 54409-1855 | 2007-02-12 |
| 1912061987 | Elite Chiropractic Antigo Sc | Chiropractor | 239 Superior St, Antigo, WI 54409-1860 | 2006-12-21 |
| 1114000213 | Nicole Suzanne Debroux | Chiropractor | 2006 Progress Blvd, Antigo, WI 54409 | 2006-10-23 |
| 1154418390 | Integrated Pain Solutions LLC | Chiropractor | N2120 County Rd S, Antigo, WI 54409-8950 | 2006-10-09 |
| 1528164738 | Bruce C Goldsworthy | Chiropractor | 941 Century Ave, Antigo, WI 54409-2484 | 2006-09-15 |
| 1255435442 | Gerald N Rindal | Chiropractor | 1029 5th Ave, Antigo, WI 54409-1458 | 2006-09-11 |
| 1548379498 | Amanda Rae Diercks | Chiropractor | 1111 Langlade Rd, Antigo, WI 54409-2738 | 2006-08-30 |
| 1245262021 | Stacy M Bula | Chiropractor | 537 Field St, Antigo, WI 54409-2229 | 2006-07-06 |
| 1104853977 | Ellen Maureen Sauer-draeger | Chiropractor | 239 Superior Street, Antigo, WI 54409-1860 | 2006-06-27 |
| Find all providers in ANTIGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.