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General NPI Number Information
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NPI Number | 1992787592
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Entity Type | Individual
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Provider Name | ALYCIA L RODGERS M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 06/18/2021
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Provider Practice Location Address
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Address Line | 600 CYPRESS ST
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City | SULPHUR
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State | LA
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Zip | 70663-5052
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Country | US
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Telephone | 337-527-6371
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Fax | 337-528-9616
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Provider Business Mailing Address
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Address Line | 600 CYPRESS ST
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City | SULPHUR
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State | LA
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Zip | 70663-5052
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Country | US
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Telephone | 337-527-6371
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Fax | 337-528-9616
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 15412R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 15412R
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 15412R
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License Number State | LA
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