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NPI Code Detail

MEDICARE: ERIN DIANE RODGERS

MEDICARE:   ERIN DIANE RODGERS
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1073087912
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN DIANE RODGERS
Provider Business Mailing Address
First Line : 2313 NW 2ND ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73107-6931
Country : US
Telephone Number : 405-837-2567
Fax Number :
Provider Business Practice Location Address
First Line : 2313 NW 2ND ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73107-6931
Country : US
Telephone Number : 405-837-2567
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2019
Last Update Date : 01/14/2019

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Directions to “ ERIN DIANE RODGERS ” Practice Location

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