Individual
CAROL L ROGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4230 HAMILTON BLVD, SIOUX CITY, IA 51104-1137
(712) 239-4900
(712) 239-2866
Mailing address
814 PIERCE ST, SUITE 102, SIOUX CITY, IA 51101-1058
(712) 226-2600
(712) 226-2605
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24959
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027201
—
IA
01
—
20082
SIOUX VALLEY
—
01
—
3879
MIDLANDS CHOICE
—
01
—
47516
WELLMARK BCBS
IA
05
—
5609423
—
SD
05
—
75305796312
—
NE
01
—
75305796351104A002
TRICARE
—
01
—
9182435
DAKOTA CERE
—
Enumeration date
03/17/2006
Last updated
02/07/2011
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