Individual
DR. ROBERT LANE ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
999 MAR WALT DRIVE, WHITE-WILSON EAST BUILDING, FORT WALTON BEACH, FL 32547
(850) 863-8255
(850) 862-7965
Mailing address
999 MAR WALT DRIVE, EAST BUILDING, FORT WALTON BEACH, FL 32547
(850) 863-8255
(850) 862-7965
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME41071
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
069716800
—
FL
01
—
47176
BCBSFL
FL
Enumeration date
12/13/2005
Last updated
01/16/2017
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