Healthcare Provider Details

I. General information

NPI: 1841262409
Provider Name (Legal Business Name): SUZANNE LAWRENCE ROGERS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. SUZANNE LAWRENCE

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 01/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5657 HIMALAYA #100
CENTENNIAL CO
80115
US

IV. Provider business mailing address

5657 HIMALAYA #100
CENTENNIAL CO
80115
US

V. Phone/Fax

Practice location:
  • Phone: 303-699-6200
  • Fax:
Mailing address:
  • Phone: 303-699-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number40367
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: