Individual
KISHA ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 MEDICAL PARK DR, BENTON, AR 72015-3353
(501) 776-6000
Mailing address
3359 KRUSE LOOP, ALEXANDER, AR 72002-8844
(479) 216-4368
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
E16978
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2019
Last updated
10/12/2023
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