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General NPI Number Information
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NPI Number | 1861580946
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Entity Type | Individual
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Provider Name | WILLIAM B ROGERS III MD
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Gender | Male
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 01/11/2019
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Provider Practice Location Address
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Address Line | 617 23RD ST STE 105
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City | ASHLAND
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State | KY
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Zip | 41101-2890
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Country | US
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Telephone | 606-408-7500
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Fax | 606-408-6600
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Provider Business Mailing Address
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Address Line | PO BOX 2379
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City | ASHLAND
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State | KY
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Zip | 41105-2379
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Country | US
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Telephone | 606-324-7146
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Fax | 606-324-5165
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 29561
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License Number State | KY
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