Organization
CROSSROADS FOOT AND ANKLE PODIATRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURENCE C ROGERS DPM (OWNER)
(574) 223-6050
Entity
Organization
Contact information
Practice address
120 E 18TH ST, ROCHESTER, IN 46975-2632
(574) 223-6050
(574) 223-3057
Mailing address
PO BOX 548, ROCHESTER, IN 46975-0548
(574) 223-6050
(574) 223-3057
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000091947
BCBS
IN
01
—
0311390001
DME
IN
05
—
100173510A
—
IN
01
—
M100060875
MEDICARE PTAN
IN
Enumeration date
12/02/2008
Last updated
05/01/2012
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