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Individual

JERRY B ROGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
ONE HOSPITAL DRIVE, COLUMBIA, MO 65212-0001
(573) 882-1647
(573) 884-6024
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
107973
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
208049916
MO
01
P00106646
RR MEDICARE
MO
01
P00419174
RAILROAD MEDICARE
MO
Enumeration date
06/01/2006
Last updated
04/25/2012
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