Individual
ANITA GAYLE ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
505 SHOPPERS DR, SUITE 3, WINCHESTER, KY 40391-2808
(859) 737-3911
(859) 737-9511
Mailing address
505 SHOPPERS DR, SUITE 3, WINCHESTER, KY 40391-2808
(859) 737-3911
(859) 737-9511
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
26795
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221170
ANTHEM PROVIDER ID
—
01
—
26795
KY MEDICAL LICENSE NUMBER
KY
05
—
6426795800
—
KY
Enumeration date
07/17/2006
Last updated
07/08/2007
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