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General NPI Number Information
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NPI Number | 1134282999
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Entity Type | Individual
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Provider Name | ROGER EARL CAGLE M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 08/17/2010
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Provider Practice Location Address
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Address Line | 2700 W KINGSHIGHWAY STE 4
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City | PARAGOULD
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State | AR
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Zip | 72450-2637
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Country | US
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Telephone | 870-239-3600
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Fax | 870-240-0643
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Provider Business Mailing Address
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Address Line | 2700 W KINGSHIGHWAY STE 4
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City | PARAGOULD
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State | AR
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Zip | 72450-2637
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Country | US
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Telephone | 870-239-3600
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Fax | 870-240-0643
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C-5380
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2002014383
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | F-4777
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License Number State | TX
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