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
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