Provider Demographics
NPI:1275641383
Name:ROGERS, JOHN BRITTAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BRITTAN
Last Name:ROGERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6401 UNIVERSITY AVE NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-4341
Mailing Address - Country:US
Mailing Address - Phone:763-572-5710
Mailing Address - Fax:763-571-3008
Practice Address - Street 1:6341 UNIVERSITY AVE NE
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-4946
Practice Address - Country:US
Practice Address - Phone:763-572-5710
Practice Address - Fax:763-586-5888
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN39421207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1011491OtherPREFERRED ONE
MN0912563OtherMEDICA
MN5723576OtherAETNA INS
MN85236OtherAMERICA'S PPO
MNHP20440OtherHEALTHPARTNERS
MN06F99ROOtherBCBS OF MN
MN990326700Medicaid
MN115120OtherUCARE MN
MN0912563OtherMEDICA
MN06F99ROOtherBCBS OF MN
MN200001517Medicare ID - Type UnspecifiedWPS MEDICARE