Healthcare Provider Details

I. General information

NPI: 1700327541
Provider Name (Legal Business Name): GREG ALMON ROGERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2017
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4021 CANAL ST
JACKSONVILLE NC
28540
US

IV. Provider business mailing address

42 W BAILEY LN
HAMPSTEAD NC
28443-3967
US

V. Phone/Fax

Practice location:
  • Phone: 910-449-6500
  • Fax:
Mailing address:
  • Phone: 850-346-4346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number158157
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number158157
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: