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General NPI Number Information
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NPI Number | 1932656857
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Entity Type | Individual
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Provider Name | JOSHUA JAMES ROGERS O.D.
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Gender | Male
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 09/16/2016
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Provider Practice Location Address
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Address Line | 13 MASSILLON MARKETPLACE DR SW
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City | MASSILLON
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State | OH
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Zip | 44646-2014
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Country | US
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Telephone | 330-880-2980
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Fax |
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Provider Business Mailing Address
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Address Line | 3034 STONEBROOKE LN
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City | MEDINA
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State | OH
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Zip | 44256-5325
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Country | US
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Telephone | 815-985-7115
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT.6511-THER
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License Number State | OH
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