# ROGERS FAMILY AND OCCUPATIONAL MEDICINE CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rogers Occupational Medical Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801869151
- **Authorized official:** TIMOTHY WAYNE YAWN MD (PRESIDENT)
- **Authorized official phone:** (479) 621-9749

## Contact information

- **Practice address:** 1615B WEST PERSIMMON, ROGERS, AR 72756
- **Practice address phone:** (479) 636-7192
- **Practice address fax:** (479) 621-9749
- **Mailing address:** 1615B WEST PERSIMMON, ROGERS, AR 72756
- **Mailing address phone:** (479) 636-7192
- **Mailing address fax:** (479) 621-9749

## Taxonomy

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

## Other

- **Enumeration date:** 02/08/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5B378 | BLUE CROSS BLUE SHIELD | AR |