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NPI Code Detail

MEDICARE: JEFFREY PHILIP ROGER M.D.

MEDICARE: JEFFREY PHILIP ROGER 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
1207RH0002XHospice and Palliative Medicine (Internal Medicine) Physician20736NV
2207RH0002XHospice and Palliative Medicine (Internal Medicine) PhysicianMD00044507WA
3207PE0004XEmergency Medical Services (Emergency Medicine) PhysicianMD00044507WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376574160
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY PHILIP ROGER M.D.
Provider Business Mailing Address
First Line : 745 W MOANA LN STE 300
Second Line :
City : RENO
State : NV
Zip : 89509-4980
Country : US
Telephone Number : 970-640-7000
Fax Number :
Provider Business Practice Location Address
First Line : 745 W MOANA LN STE 300
Second Line :
City : RENO
State : NV
Zip : 89509-4980
Country : US
Telephone Number : 970-640-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2006
Last Update Date : 12/02/2022

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