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NPI Code Detail

MEDICARE: JEROME JOHN ROGICH MS, MD, DIMM

MEDICARE: JEROME JOHN ROGICH MS, MD, DIMM
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
1207PE0004XEmergency Medical Services (Emergency Medicine) PhysicianA780935AZ
2207P00000XEmergency Medicine PhysicianA174255CA

General Provider Information

NPI Number : 1881190403
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEROME JOHN ROGICH MS, MD, DIMM
Provider Business Mailing Address
First Line : 1200 N BEAVER ST
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86001-3118
Country : US
Telephone Number : 928-214-3930
Fax Number : 928-214-3882
Provider Business Practice Location Address
First Line : 1200 N BEAVER ST
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86001-3118
Country : US
Telephone Number : 928-779-3366
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2018
Last Update Date : 03/06/2026

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Directions to “ JEROME JOHN ROGICH MS, MD, DIMM” Practice Location

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