Provider Demographics
NPI:1053618017
Name:ROTAN INC.
Entity type:Organization
Organization Name:ROTAN INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:SYME
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-622-1091
Mailing Address - Street 1:PO BOX 2176
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81302-2176
Mailing Address - Country:US
Mailing Address - Phone:702-622-1091
Mailing Address - Fax:702-968-8635
Practice Address - Street 1:575 RIVERGATE
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-7487
Practice Address - Country:US
Practice Address - Phone:702-622-1091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-27
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47209207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV153784Medicare UPIN
NVAX946ZMedicare PIN