Provider Demographics
NPI:1134293533
Name:JOHN CHARLES ROGERS MD LTD
Entity Type:Organization
Organization Name:JOHN CHARLES ROGERS MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-321-9111
Mailing Address - Street 1:3738 S 60TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53220-1935
Mailing Address - Country:US
Mailing Address - Phone:414-321-9111
Mailing Address - Fax:414-321-9112
Practice Address - Street 1:3738 S 60TH ST STE 102
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53220-1935
Practice Address - Country:US
Practice Address - Phone:414-321-9111
Practice Address - Fax:414-321-9112
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHN CHARLES ROGERS MD LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-17
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty