Individual
JOHN E ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
502 LEGACY PLZ W, LA PORTE, IN 46350-5254
(219) 575-6240
(219) 369-4233
Mailing address
PO BOX 1690, LA PORTE, IN 46352-1690
(219) 326-2312
(219) 326-2584
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01045174
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000079444
ANTHEM, BCBS
IN
05
—
200150020A
—
IN
Enumeration date
08/07/2006
Last updated
08/14/2015
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