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General NPI Number Information
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NPI Number | 1194798751
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Entity Type | Individual
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Provider Name | JEFFREY PHILLIP ROGERS M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2500 W LAYTON AVE SUITE 200
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City | MILWAUKEE
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State | WI
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Zip | 53221-5420
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Country | US
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Telephone | 414-281-3444
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Fax | 414-281-6522
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Provider Business Mailing Address
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Address Line | 12116 HWY 60
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City | CEDARBURG
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State | WI
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Zip | 53012-9335
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Country | US
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Telephone | 262-376-2992
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Fax | 414-281-6522
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 23216
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License Number State | WI
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