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Individual

ROBERT OLIVER RODGERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
30 E APPLE ST STE 2200, DAYTON, OH 45409-2939
(937) 208-2091
(937) 208-4007
Mailing address
3170 KETTERING BLVD BLDG B3, MORAINE, OH 45439-1924
(937) 991-3188

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.399298
OH
363L00000X
Nurse Practitioner
Primary
APRN.CNP.023449
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0334095
OH
Enumeration date
06/20/2018
Last updated
10/26/2020
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