National Provider Identifier Database

ROTH FAMILY MEDICINE AND MENTAL HEALTH
Primary Care


Contact Information

ROTH FAMILY MEDICINE AND MENTAL HEALTH
444 HOSPITAL WAY. SUITE 422
POCATELLO, ID83201
Phone: 208-904-4705
Fax: 208-203-6420
Specialty Taxonomy Code
* Primary Care 261QP2300X

* Indicates primary specialty

NPI Profile & details for ROTH FAMILY MEDICINE AND MENTAL HEALTH

NPI Number 1144168881
Legal business name
LBN
ROTH FAMILY MEDICINE AND MENTAL HEALTH
Authorized official KYLE ROTH - (OWNER OPERATOR)
Entity Organization
Organization subpart No
Enumeration date 03/24/2026
Last updated 03/24/2026 - About 2 months ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for ROTH FAMILY MEDICINE AND MENTAL HEALTH

There are currently no reviews for ROTH FAMILY MEDICINE AND MENTAL HEALTH


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