Individual
THEODORE ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
212 HOSPITAL LN STE 101, PERRYVILLE, MO 63775
(573) 547-7888
Mailing address
212 HOSPITAL LN STE 101, PERRYVILLE, MO 63775-4204
(573) 547-7888
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2017019110
MO
Other
Enumeration date
05/15/2013
Last updated
05/24/2018
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