Healthcare Provider Details

I. General information

NPI: 1942208434
Provider Name (Legal Business Name): JAMES W ROGERS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 07/24/2024
Certification Date: 05/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 MAIN STREET
CASSVILLE MO
65625
US

IV. Provider business mailing address

92 MAIN STREET
CASSVILLE MO
65625
US

V. Phone/Fax

Practice location:
  • Phone: 417-847-5225
  • Fax: 417-847-5425
Mailing address:
  • Phone: 512-483-9569
  • Fax: 512-406-6216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberN1431
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: