Dr Kristiansson Roth, PHD is a
Psychologist based in Cordele, Georgia. Dr Kristiansson Roth is licensed to practice in Georgia (license number PSY002706) and his current practice location is
304 E 14th Ave, Cordele, Georgia. He can be reached at his office (for appointments etc.) via phone at
(229) 273-7392.
NPI number for Dr Kristiansson Roth is 1205050283 and his current mailing address is 304 E 14th Ave, Cordele, Georgia. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1205050283.
Healthcare Provider's Profile
| Full Name | Dr Kristiansson Roth |
|---|
| Gender | Male |
|---|
| Speciality | Psychologist |
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| Location | 304 E 14th Ave, Cordele, Georgia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1205050283
- Provider Enumeration Date: 04/12/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Dr Kristiansson Roth such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1205050283 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | PSY002706 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kristiansson Roth is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Kristiansson Roth, PHD
304 E 14th Ave,
Cordele, GA 31015-1423
Ph: (229) 273-7392 | Dr Kristiansson Roth, PHD
304 E 14th Ave,
Cordele, GA 31015-1423
Ph: (229) 273-7392 |
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