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General NPI Number Information
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NPI Number | 1285918805
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Entity Type | Organization
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Legal Business Name | STEPHEN E. ROGERS, MB.CHB.,LLC
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Dates
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Enumeration Date | 09/30/2011
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Last Update Date | 09/30/2011
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Provider Practice Location Address
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Address Line | 4700 WATERS AVE SUITE 109
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City | SAVANNAH
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State | GA
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Zip | 31404-6220
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Country | US
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Telephone | 912-224-4874
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Fax | 912-350-0774
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Provider Business Mailing Address
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Address Line | PO BOX 13548
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City | SAVANNAH
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State | GA
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Zip | 31416-0548
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Country | US
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Telephone | 912-224-4874
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Fax | 912-350-0774
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Authorized Official
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Title or Position | MEMBER/MANAGER
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Name | STEPHEN E ROGERS
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Credential | MB CHB
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Telephone | 912-224-4874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 026180
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License Number State | GA
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