Individual
PAUL GERARD ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, MPAS
Contact information
Practice address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
(785) 240-7652
(785) 240-8351
Mailing address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
(785) 239-7863
(785) 240-8203
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
15-01618
KS
363AM0700X
Medical Physician Assistant
Primary
15-01618
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134199532
NPI
—
Enumeration date
01/26/2006
Last updated
12/06/2021
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