Healthcare Provider Details

I. General information

NPI: 1902082365
Provider Name (Legal Business Name): DAVID J ROGERS P.A.-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2008
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 COUNTY RD
BARRINGTON RI
02806-4545
US

IV. Provider business mailing address

15 LA SALLE SQ
PROVIDENCE RI
02903-1814
US

V. Phone/Fax

Practice location:
  • Phone: 401-606-3550
  • Fax: 401-606-2591
Mailing address:
  • Phone: 401-444-6779
  • Fax: 401-444-6912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA01106
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: