Rogers, Russell Kevin

Rogers, Russell Kevin is an sole proprietor health care provider with primary practice located at 1461 N Gardner St , Scottsburg IN 47170-7751. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Rogers, Russell Kevin can be contacted via phone (812) 752-4656.

Contact Information

Primary practice address
1461 N Gardner St Scottsburg IN 47170-7751
Phone: (812) 752-4656
Fax: (812) 752-4919
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01035467 Indiana

Profile Details

NPI number 1609857259
LBN Legal business name Rogers, Russell Kevin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 10th, 2005
Last updated Jul 29th, 2010 - about 14 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 1609857259 NPPES
Indiana MEDICAID 100221450A
Indiana Other 000000042514

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