Individual
EDWIN SAMUEL ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, ABPP
Contact information
Practice address
1924 ALCOA HWY, U-115, KNOXVILLE, TN 37920-1511
(865) 544-9351
(865) 544-9314
Mailing address
1924 ALCOA HWY, U-67, KNOXVILLE, TN 37920-1511
(865) 544-9352
(865) 544-9314
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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