Provider Demographics
NPI:1306844428
Name:ROGERS, JAMES R (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:ROGERS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:615 E OKLAHOMA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-5951
Mailing Address - Country:US
Mailing Address - Phone:580-233-4711
Mailing Address - Fax:580-234-6686
Practice Address - Street 1:615 E OKLAHOMA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-5951
Practice Address - Country:US
Practice Address - Phone:580-233-4711
Practice Address - Fax:580-234-6686
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2011-03-09
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Provider Licenses
StateLicense IDTaxonomies
OK14789207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100729900AMedicaid
OK180016429OtherRAILROAD MEDICARE
OK0748750001OtherCIGNA DMERC
OK0748750001OtherCIGNA DMERC