Individual
TED B ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
908 WALLACE AVE, LEITCHFIELD, KY 42754
(270) 230-0124
(270) 230-0157
Mailing address
908 WALLACE AVE, LEITCHFIELD, KY 42754-1479
(270) 259-0124
(270) 230-0157
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35858
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000341623
ANTHEM
KY
01
—
2446228000
PASSPORT ADVANTAGE
KY
01
—
50004884
PASSPORT
KY
05
—
64086291
—
KY
Enumeration date
05/27/2005
Last updated
03/12/2020
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