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NPI Code Detail

MEDICARE: DR. STACI DAWN ROGERS M.D.

MEDICARE: DR. STACI DAWN ROGERS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician2008002542MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043428121
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STACI DAWN ROGERS M.D.
Provider Business Mailing Address
First Line : PO BOX 802843
Second Line :
City : KANSAS CITY
State : MO
Zip : 64180-2843
Country : US
Telephone Number : 417-730-6430
Fax Number : 417-269-7567
Provider Business Practice Location Address
First Line : 3800 S NATIONAL AVE STE 700
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-5279
Country : US
Telephone Number : 417-269-8817
Fax Number : 417-269-8744
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2007
Last Update Date : 12/08/2023

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