Rodgers, Jerry Wharton
Rodgers, Jerry Wharton is an individual health care provider with primary practice located at 18780 Interstate 20 , Canton TX 75103-3593. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Rodgers, Jerry Wharton can be contacted via phone (903) 567-7748.Contact Information
Primary practice address
18780 Interstate 20
Canton TX 75103-3593
Phone: (903) 567-7748
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | D5180 | Texas |
Profile Details
| NPI number | 1942218359 |
|---|---|
| LBN Legal business name | Rodgers, Jerry Wharton |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 3rd, 2006 |
| Last updated | Oct 13th, 2014 - about 10 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 | 1942218359 | NPPES |
| Texas | MEDICAID | 039171607 | |
| Texas | Other | P01069945 | |
| Texas | Other | 752616977028 | |
| Texas | Other | 752616977001 | |
| Texas | Other | 86426F | |
| Texas | Other | 8V0575 | |
| Texas | MEDICAID | 039171606 | |
| Texas | MEDICAID | 1701864-01 |
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