Provider Demographics
NPI:1417964628
Name:ROGERS, JUDSON E (MD)
Entity Type:Individual
Prefix:
First Name:JUDSON
Middle Name:E
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 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-851-6033
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:1916 PATTERSON ST
Practice Address - Street 2:STE 300
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2120
Practice Address - Country:US
Practice Address - Phone:615-327-1737
Practice Address - Fax:615-327-1732
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD016874207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN110210678OtherRAILROAD MEDICARE
TN3154198OtherBLUE CROSS BLUE SHIELD
TN6039710OtherBCBS
TN3857527Medicaid
TNQ014145Medicaid
TN110210678OtherRAILROAD MEDICARE
TNQ014145Medicaid