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General NPI Number Information
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NPI Number | 1548315971
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Entity Type | Organization
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Legal Business Name | THE ROGERS CLINIC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 10/05/2007
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Provider Practice Location Address
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Address Line | 727 E WYANDOTTE AVE
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City | MCALESTER
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State | OK
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Zip | 74501-5427
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Country | US
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Telephone | 918-423-5599
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Fax | 918-423-5563
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Provider Business Mailing Address
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Address Line | 727 E WYANDOTTE AVE
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City | MCALESTER
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State | OK
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Zip | 74501-5427
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Country | US
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Telephone | 918-423-5599
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Fax | 918-423-5563
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Authorized Official
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Title or Position | DOCTOR
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Name | GREGORY ROGERS
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Credential | DO
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Telephone | 918-423-5599
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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 |
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License Number State |
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