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General NPI Number Information
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NPI Number | 1790766558
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Entity Type | Individual
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Provider Name | DAVID B ROGERS M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 12/31/2013
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Provider Practice Location Address
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Address Line | 1155 W. PARKVIEW ST. SUITE 2D
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City | BOLIVAR
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State | MO
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Zip | 65613-7800
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Country | US
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Telephone | 417-777-2663
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Fax | 417-777-2666
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Provider Business Mailing Address
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Address Line | 1155 W. PARKVIEW ST. SUITE 2D
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City | BOLIVAR
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State | MO
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Zip | 65613-7800
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Country | US
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Telephone | 417-777-2663
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Fax | 417-777-2666
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | R9H97
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License Number State | MO
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