Individual
LESLIE ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2809 N PARK DRIVE LN, APPLETON, WI 54911-1603
(920) 738-4600
(920) 738-4792
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
(920) 996-3298
(920) 738-5787
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42488
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33345900
—
WI
Enumeration date
06/23/2006
Last updated
07/08/2007
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