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Individual

HALEIGH T RODGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1800 N CAPITOL AVE, E-140, INDIANAPOLIS, IN 46202-1218
(317) 962-8776
(317) 963-5285
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002064A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000001034507
ANTHEM PTAN
IN
01
068010305
MEDICARE PTAN
IN
01
266430789
MEDICARE PTAN
IN
01
267030221
MEDICARE PTAN
IN
05
300023448
IN
01
Q00098268
RAILROAD PTAN
IN
Enumeration date
07/21/2016
Last updated
02/15/2025
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