Individual
EDWIN SAMUEL ROGERS
Active
Individual
EDWIN SAMUEL ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, ABPP
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P740
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689631137
GROUP NPI
TN
01
—
3373352
UFP MEDICAID GRP
TN
01
—
3680230
AETNA
TN
01
—
680011669
RAILROAD MEDICARE
—
01
—
TN01H8
JOHN DEERE
TN
Enumeration date
05/01/2006
Last updated
09/28/2012
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