MEDICARE: DR. CORNEL TYRONE 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	207T00000X	Neurological Surgery Physician	MD.205757	LA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	2084N0600X	Clinical Neurophysiology Physician	MD.205757	LA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750605770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CORNEL TYRONE ROGERS M.D.

Provider Business Mailing Address
First Line	:	196 ENGLISH TURN DR
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70131-3328
Country	:	US
Telephone Number	:	504-388-4735
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 OCHSNER BLVD STE 420
Second Line	:
City	:	GRETNA
State	:	LA
Zip	:	70056-5250
Country	:	US
Telephone Number	:	504-391-7547
Fax Number	:	504-391-7549

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

Provider Enumeration Date	:	03/19/2010
Last Update Date	:	04/26/2023

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