Provider Demographics
NPI:1548315971
Name:THE ROGERS CLINIC
Entity type:Organization
Organization Name:THE ROGERS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:918-423-5599
Mailing Address - Street 1:727 E WYANDOTTE AVE
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-5427
Mailing Address - Country:US
Mailing Address - Phone:918-423-5599
Mailing Address - Fax:918-423-5563
Practice Address - Street 1:727 E WYANDOTTE AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5427
Practice Address - Country:US
Practice Address - Phone:918-423-5599
Practice Address - Fax:918-423-5563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty