MEDICARE: DR. LAURA ELIZABETH ROGERS 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
1	207Q00000X	Family Medicine Physician	MD200184	LA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00980759	OTHER	LA	MEDICARE RR

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

General Provider Information

NPI Number	:	1912992868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA ELIZABETH ROGERS MD

Provider Business Mailing Address
First Line	:	307 ANNUNCIATION ST
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-6044
Country	:	US
Telephone Number	:	337-280-5741
Fax Number	:

Provider Business Practice Location Address
First Line	:	2130 KALISTE SALOOM RD
Second Line	:	SUITE 101
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-6143
Country	:	US
Telephone Number	:	337-981-5466
Fax Number	:

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

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	12/15/2011

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