Provider Demographics
NPI:1437126497
Name:ROGERS, GAYLON RENARD (MD)
Entity Type:Individual
Prefix:DR
First Name:GAYLON
Middle Name:RENARD
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 1:2018 BROOKWOOD MEDICAL CTR DR
Mailing Address - Street 2:PROFESSIONAL OFFICE BUILDING SUITE 315
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6898
Mailing Address - Country:US
Mailing Address - Phone:205-877-2747
Mailing Address - Fax:205-877-2526
Practice Address - Street 1:2018 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:PROFESSIONAL OFFICE BUILDING SUITE 315
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6898
Practice Address - Country:US
Practice Address - Phone:205-877-2747
Practice Address - Fax:205-877-2526
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00006106207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-48812OtherBCBS - UAB SURGERY
AL000025139Medicaid
AL25139OtherBCBS BROOKWOOD
AL25531OtherBCBS UAB
AL515-44455OtherBCBS - BROOKWOOD SURGERY
AL000025531Medicaid
ALD08194Medicare PIN
AL000025531Medicaid
AL25531OtherBCBS UAB
ALI286Medicare PIN
AL000025139Medicare PIN