Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OS 8096 | FL |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | OS 8096 | FL |
NPI | 1386641322 |
---|---|
Provider Name | Douglas A Rogers |
First Address | Chiefland, FL 32626 |
Second Address | Chiefland, FL 32626-1911 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2005 |
Last Update Date | 30/05/2017 |