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Individual

ROGER D SMALLIGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, MPH

Contact information

Practice address
301 GOVERNORS DR SW, HUNTSVILLE, AL 35801-5123
(256) 536-5511
Mailing address
1400 WALLACE BLVD, ATTN: CREDENTIALING DEPT., AMARILLO, TX 79106-1708
(806) 354-5585
(806) 356-4673

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD.35626
AL
207R00000X
Internal Medicine Physician
MD21385
TN
207R00000X
Internal Medicine Physician
N4758
TX
208000000X
Pediatrics Physician
21385
TN
208000000X
Pediatrics Physician
N4758
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200263280 A
OK
05
205346401
TX
05
205346402
TX
01
205346403
MEDICAID - CSHCN
TX
05
40572889
NM
05
4086850
TN
Enumeration date
10/06/2005
Last updated
01/19/2023
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