Rogers, Gary L

Rogers, Gary L is an individual health care provider with primary practice located at 34 Oak St , East Ellijay GA 30540-8151. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Rogers, Gary L can be contacted via phone (706) 636-5679.

Contact Information

Primary practice address
34 Oak St East Ellijay GA 30540-8151
Phone: (706) 636-5679
Fax: (706) 636-5680
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1824 Georgia
Behavioral Health & Social Service Providers / Forensic 103TF0200X 1824 Georgia

Profile Details

NPI number 1922172683
LBN Legal business name Rogers, Gary L
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922172683 NPPES
Georgia MEDICAID 00626315E

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