Individual
TRENT D. ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 WEST TIETAN STREET, WALLA WALLA, WA 99362-4445
(509) 525-3720
(509) 522-1593
Mailing address
55 WEST TIETAN STREET, WALLA WALLA, WA 99362-4445
(509) 525-3720
(509) 522-1593
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2000150925
MO
208000000X
Pediatrics Physician
Primary
MD60150941
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
129168
BLUE CROSS BLUE SHIELD
—
01
—
1834225
FIRST HEALTH
—
01
—
204956502
MEDICAID
MO
05
—
204956502
—
MO
01
—
207515500
MEDICAID
MO
01
—
3269222
CIGNA
—
01
—
440546366
UNITED HEALTHCARE
—
01
—
4435458
HEALTHLINK
—
01
—
H13706
MERCY
—
Enumeration date
04/20/2006
Last updated
07/15/2010
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