Provider Demographics
NPI:1720421290
Name:ROUTH, JOSHUA K (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:K
Last Name:ROUTH
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 1:1 N 1ST ST STE 700
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-2364
Mailing Address - Country:US
Mailing Address - Phone:602-649-4498
Mailing Address - Fax:602-610-4757
Practice Address - Street 1:1 N 1ST ST STE 700
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-2364
Practice Address - Country:US
Practice Address - Phone:602-481-9650
Practice Address - Fax:602-610-4757
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ56886207ZP0007X
NMMD2017-0765207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic Pathology