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NPI Code Detail

MEDICARE: TYLER LYNNE ROGERS PA-C

MEDICARE: TYLER LYNNE ROGERS PA-C
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
1363A00000XPhysician Assistant13713GA

General Provider Information

NPI Number : 1164373106
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER LYNNE ROGERS PA-C
Provider Business Mailing Address
First Line : 150 GENTILLY BLVD
Second Line :
City : CARTERSVILLE
State : GA
Zip : 30120-8522
Country : US
Telephone Number : 470-490-6445
Fax Number :
Provider Business Practice Location Address
First Line : 150 GENTILLY BLVD
Second Line :
City : CARTERSVILLE
State : GA
Zip : 30120-8522
Country : US
Telephone Number : 470-490-6445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2026
Last Update Date : 02/05/2026

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Directions to “ TYLER LYNNE ROGERS PA-C” Practice Location

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