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Individual

ROMAN ROGOZIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
879 TERRACESIDE CIR, CLARKSVILLE, TN 37040-6175
(726) 400-1012

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1236757
TN

Other

Enumeration date
05/07/2024
Last updated
12/15/2025
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