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Organization

CLAYTON W. ROGERS ED D

Active
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Organization

CLAYTON W. ROGERS ED D

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CLAYTON WAYNE ROGERS ED, D, (CLINICAL PSYCHOLOGIST/OWNER)
(918) 342-2622
Entity
Organization

Contact information

Practice address
2990 N SIOUX AVE, CLAREMORE, OK 74017-3700
(918) 342-2622
(918) 342-2641
Mailing address
2990 N SIOUX AVE, CLAREMORE, OK 74017-3700
(918) 342-2622

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
416
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100840930A
OK
01
OKB5288
MEDICARE PTAN
OK
Enumeration date
07/14/2008
Last updated
09/27/2012
Update your record

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