MEDICARE: DR. GARRETT L ROGERS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	21109	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093711962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARRETT L ROGERS M.D.

Provider Business Mailing Address
First Line	:	3080 HENDERSON DR
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-5246
Country	:	US
Telephone Number	:	910-353-3000
Fax Number	:	910-238-4456

Provider Business Practice Location Address
First Line	:	3080 HENDERSON DR
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-5246
Country	:	US
Telephone Number	:	910-353-3000
Fax Number	:	910-238-4456

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	06/11/2013

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