Individual
JERRY P ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 BELSLY BLVD, MOORHEAD, MN 56560-5055
(701) 364-6800
(701) 364-6828
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-3300
(701) 364-8906
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25477
MN
207Q00000X
Family Medicine Physician
4728
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0106001
MEDICA #
MN
01
—
0106002
MEDICA #
ND
01
—
0108164
MEDICA #
ND
01
—
080039937
RAILROAD
MN
01
—
122946
UCARE #
MN
05
—
14614
—
MN
01
—
15959
SIOUX VALLEY #
MN
01
—
1739
NDBS #
ND
01
—
27362RO
MNBS #
NC
01
—
28527RO
MNBS #
ND
01
—
6439
NDBS #
MN
01
—
664582
AMERICA'S PPO/ARAZ #
MN
01
—
83D94RO
MNBS #
MN
05
—
944307000
—
MN
01
—
DA9011015630
PREFERRED ONE #
MN
01
—
HP19577
HEALTHPARTNERS #
MN
01
—
MN100035
LHS #
MN
Enumeration date
07/03/2006
Last updated
10/21/2011
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