Organization
LARRY C. ROGERS
Active
Other names
Petersburg Medical Group II
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY C ROGERS MD (OWNER)
(304) 257-4511
Entity
Organization
Contact information
Practice address
MEMORIAL DR, PETERSBURG, WV 26847
(304) 257-4511
(304) 257-4511
Mailing address
MEMORIAL DR BOX 7, PETERSBURG, WV 26847
(304) 257-4511
(304) 257-4511
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0055759000
—
WV
Enumeration date
02/07/2008
Last updated
08/19/2008
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