Individual
DR. KENNETH A ROGERS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3435 NW 56TH, SUITE 711A, OKLAHOMA CITY, OK 73112
(405) 945-4222
(405) 945-4322
Mailing address
3435 NW 56TH, SUITE 711A, OKLAHOMA CITY, OK 73112
(405) 945-4222
(405) 945-4322
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
7794
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040004090
RR MEDICARE
—
05
—
100212110A
—
OK
Enumeration date
09/25/2006
Last updated
07/23/2008
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