Provider Demographics
NPI:1134570401
Name:RODGERS, EMILY INGE WEBB (DO)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:INGE WEBB
Last Name:RODGERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:RODGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1438 S GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-1027
Mailing Address - Country:US
Mailing Address - Phone:314-977-4850
Mailing Address - Fax:314-977-4880
Practice Address - Street 1:1438 S GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1027
Practice Address - Country:US
Practice Address - Phone:314-977-4850
Practice Address - Fax:314-977-4880
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20180086482084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry