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NPI Code Detail

MEDICARE: ROGER ALAN HISER MD

MEDICARE:   ROGER ALAN HISER  MD
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) Physician48899GA
2207R00000XInternal Medicine Physician48899GA

General Provider Information

NPI Number : 1528064581
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROGER ALAN HISER MD
Provider Business Mailing Address
First Line : 221 TECHNOLOGY PKWY NW
Second Line :
City : ROME
State : GA
Zip : 30165-1369
Country : US
Telephone Number : 762-235-1000
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 : 470-490-6030
Fax Number : 470-490-6029
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 05/08/2020

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Directions to “ ROGER ALAN HISER MD” Practice Location

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