Individual
STEPHEN ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
424 YELLOWSTONE AVE, SUITE 140, CODY, WY 82414-9309
(307) 527-7100
(307) 527-7145
Mailing address
424 YELLOWSTONE AVE, SUITE 140, CODY, WY 82414-9309
(307) 527-7100
(307) 527-7145
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PT650
WY
363AS0400X
Surgical Physician Assistant
Primary
MED-PAC-LIC-68103
MT
Other
Enumeration date
10/01/2015
Last updated
12/14/2021
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