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Individual

MR. JOHN KITCHENER ROGERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
110 GEORGETOWN CT, MACON, GA 31210-3076
(478) 471-6672
Mailing address
110 GEORGETOWN CT, MACON, GA 31210-3076
(478) 471-6672

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN095473 CRNA
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0005470Z7D
GA
Enumeration date
05/30/2005
Last updated
06/19/2012
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