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NPI Code Detail

MEDICARE: DR. STEPHEN KYLE ROGERS M.D.

MEDICARE: DR. STEPHEN KYLE 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
1207Q00000XFamily Medicine Physician01054781AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5P00018889OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17641531OTHERAETNA
2020300900OTHERFEDCERAL BLACK LUNG
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4000000296595OTHERANTHEM BLUE CROSS

General Provider Information

NPI Number : 1609879675
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN KYLE ROGERS M.D.
Provider Business Mailing Address
First Line : 3400 LAFAYETTE RD STE 200
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46222-1147
Country : US
Telephone Number : 317-291-7422
Fax Number : 317-291-7433
Provider Business Practice Location Address
First Line : 3400 LAFAYETTE RD STE 200
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46222-1147
Country : US
Telephone Number : 317-291-7422
Fax Number : 317-291-7433
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 04/03/2026

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