Provider Demographics
NPI:1285656652
Name:ROGERS, JOHN SIMS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SIMS
Last Name:ROGERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 15004
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37901
Mailing Address - Country:US
Mailing Address - Phone:865-522-9730
Mailing Address - Fax:865-637-2520
Practice Address - Street 1:2100 W CLINCH AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2219
Practice Address - Country:US
Practice Address - Phone:865-637-8481
Practice Address - Fax:865-637-9959
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000024782174400000X, 2080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3079515Medicaid
TN0180359OtherBCBS
TN0180359OtherBCBS