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General NPI Number Information
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NPI Number | 1033381504
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Entity Type | Organization
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Legal Business Name | LIMA EAR NOSE AND THROAT SPECIALISTS, LLC
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Dates
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Enumeration Date | 03/25/2008
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Last Update Date | 03/26/2008
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Provider Practice Location Address
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Address Line | 770 W HIGH ST SUITE 460
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City | LIMA
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State | OH
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Zip | 45801-3990
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Country | US
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Telephone | 419-224-5111
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Fax |
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Provider Business Mailing Address
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Address Line | 770 W HIGH ST SUITE 460
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City | LIMA
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State | OH
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Zip | 45801-3990
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Country | US
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Telephone | 419-224-5111
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROGERS T ROGERS
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Credential | MD
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Telephone | 419-224-5111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 35084101
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License Number State | OH
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