Provider Demographics
NPI:1093912693
Name:ROGERS, AIMEE ELISE (MD)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:ELISE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 ST ANTHONY WAY
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-3800
Mailing Address - Country:US
Mailing Address - Phone:541-966-0535
Mailing Address - Fax:541-966-0574
Practice Address - Street 1:3001 ST ANTHONY WAY
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801
Practice Address - Country:US
Practice Address - Phone:541-278-0535
Practice Address - Fax:541-966-0574
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01072434A208800000X, 2088F0040X
ORMD179156208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No2088F0040XAllopathic & Osteopathic PhysiciansUrologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000814023OtherANTHEM
IN201149850Medicaid
OR500719528Medicaid