Fogg, Roger M
Fogg, Roger M is an sole proprietor health care provider with primary practice located at 8600 New Hope Rd , Grants Pass OR 97527-8978. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Fogg, Roger M can be contacted via phone (541) 862-2836.Contact Information
Primary practice address
8600 New Hope Rd
Grants Pass OR 97527-8978
Phone: (541) 862-2836
Fax: (541) 862-2806
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 200350113NP FNP-PP | Oregon |
Profile Details
| NPI number | 1558467852 |
|---|---|
| LBN Legal business name | Fogg, Roger M |
| Credentials | FNP-C |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 15th, 2006 |
| Last updated | Jul 2nd, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558467852 | NPPES |
| Oregon | MEDICAID | 298515 |
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