# LARRY C. ROGERS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Petersburg Medical Group II
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538347943
- **Authorized official:** LARRY C ROGERS MD (OWNER)
- **Authorized official phone:** (304) 257-4511

## Contact information

- **Practice address:** MEMORIAL DR, PETERSBURG, WV 26847
- **Practice address phone:** (304) 257-4511
- **Practice address fax:** (304) 257-4511
- **Mailing address:** MEMORIAL DR BOX 7, PETERSBURG, WV 26847
- **Mailing address phone:** (304) 257-4511
- **Mailing address fax:** (304) 257-4511

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/07/2008
- **Last updated:** 08/19/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0055759000 | — | WV |