Organization
KENNETH F RODGERS MD PA
Active
Parent organization
KENNETH F RODGERS MD PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENNETH F RODGERS MD PA
Authorized official
KENNETH F RODGERS M.D. (OWNER)
(870) 236-2202
Entity
Organization
Contact information
Practice address
1707 LINWOOD DRIVE, SUITE A, PARAGOULD, AR 72450
(870) 236-2202
(870) 236-8428
Mailing address
1707 LINWOOD DRIVE, SUITE A, PARAGOULD, AR 72450
(870) 236-2202
(870) 236-8428
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
C7528
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118700001
—
AR
01
—
209217702
GTE DATA SERVICES MEDICAI
MO
Enumeration date
11/30/2007
Last updated
11/22/2016
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