Provider Demographics
NPI:1538815881
Name:ROGERS, JOSEPH LEE JR
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:LEE
Last Name:ROGERS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 JOSEPH AVE
Mailing Address - Street 2:
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-4125
Mailing Address - Country:US
Mailing Address - Phone:234-567-6732
Mailing Address - Fax:
Practice Address - Street 1:1918 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-3818
Practice Address - Country:US
Practice Address - Phone:419-425-5050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty