Provider Demographics
NPI:1386641322
Name:ROGERS, DOUGLAS A (DO)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:A
Last Name:ROGERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1113 NW 23RD AVE
Mailing Address - Street 2:CHIEFLAND MEDICAL CENTER LLC
Mailing Address - City:CHIEFLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32626
Mailing Address - Country:US
Mailing Address - Phone:352-493-9500
Mailing Address - Fax:352-493-7070
Practice Address - Street 1:1113 NW 23RD AVE
Practice Address - Street 2:
Practice Address - City:CHIEFLAND
Practice Address - State:FL
Practice Address - Zip Code:32626-1911
Practice Address - Country:US
Practice Address - Phone:352-493-9500
Practice Address - Fax:352-493-7070
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 8096207QH0002X, 207Q00000X
FLOS8096208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine