Organization Name: | PAUL ROGERS MD |
NPI Number: | 1578797882 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAUL ROGERS (PROPRIETOR/PHYSICIAN) |
Mailing Address: | 224 Railroad St. Johnson |
State: | VT US |
Postal Code: | 05656 |
Phone Number: | 8026357325 |
Fax Number: | 8026359825 |
NPI Enumeration Date: | 05/14/2009 |
NPI Last Update Date: | 05/14/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 042-0006199 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |