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General NPI Number Information
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NPI Number | 1992485536
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Entity Type | Individual
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Provider Name | AVERY HOPE ROGERS PA
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Gender | Female
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Dates
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Enumeration Date | 07/19/2023
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 3525 OLENTANGY RIVER RD STE 5320
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City | COLUMBUS
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State | OH
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Zip | 43214-3937
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Country | US
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Telephone | 614-566-1997
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Fax |
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Provider Business Mailing Address
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Address Line | 6901 TRAIL PATH DR
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City | LEWIS CENTER
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State | OH
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Zip | 43035-7875
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Country | US
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Telephone | 419-577-9522
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.008317RX
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License Number State | OH
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