Healthcare Provider Details

I. General information

NPI: 1841274222
Provider Name (Legal Business Name): THOMAS JAMES ROGERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SCHOFIELD BARRACKS TROOP MEDICAL CLINIC
SCHOFIELD BARRACKS HI
96857
US

IV. Provider business mailing address

194 JASMINE PL #102
HONOLULU HI
96818
US

V. Phone/Fax

Practice location:
  • Phone: 808-655-1900
  • Fax: 808-655-8190
Mailing address:
  • Phone: 808-839-9437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35-06-8195-R
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: