Healthcare Provider Details

I. General information

NPI: 1104526342
Provider Name (Legal Business Name): ROGERS SURGICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2023
Last Update Date: 08/19/2023
Certification Date: 08/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2102 IDAHO STREET
ELKO NV
89801
US

IV. Provider business mailing address

6838 EMPIRE CLIFF ST
NORTH LAS VEGAS NV
89084-2583
US

V. Phone/Fax

Practice location:
  • Phone: 775-389-5777
  • Fax:
Mailing address:
  • Phone: 214-458-9132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW P ROGERS
Title or Position: MANAGER
Credential: MD
Phone: 214-458-9132