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Individual

KENNETH ROGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6100 PAN AMERICAN EAST FWY NE, 100, ALBUQUERQUE, NM 87109-3427
(505) 727-6200
(505) 727-9590
Mailing address
6100 PAN AMERICAN EAST FWY NE, 100, ALBUQUERQUE, NM 87109-3427
(505) 727-6200
(505) 727-9590

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
80242
NM
207R00000X
Internal Medicine Physician
Primary
80242
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00017236
NM
Enumeration date
09/15/2006
Last updated
08/12/2015
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