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Individual

MICHAEL L ROGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3344 N FUTRALL DR, FAYETTEVILLE, AR 72703-4057
(479) 521-8200
(479) 582-7310
Mailing address
PO BOX 1523, FAYETTEVILLE, AR 72702-1523
(479) 521-8200
(479) 582-7310

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
C-6660
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100080180A
OK
05
117248001
AR
01
53496
AR BC/BS
AR
01
P00186089
RR MCR
AR
Enumeration date
06/23/2006
Last updated
07/02/2012
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