MEDICARE: DAVID J ROGERS P.A.-C

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
1	363A00000X	Physician Assistant	PA01106	RI

General Provider Information

NPI Number	:	1902082365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID J ROGERS P.A.-C

Provider Business Mailing Address
First Line	:	15 LA SALLE SQ
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02903-1814
Country	:	US
Telephone Number	:	401-444-6779
Fax Number	:	401-444-6912

Provider Business Practice Location Address
First Line	:	236 COUNTY RD
Second Line	:
City	:	BARRINGTON
State	:	RI
Zip	:	02806-4545
Country	:	US
Telephone Number	:	401-606-3550
Fax Number	:	401-606-2591

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2008
Last Update Date	:	12/11/2025

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