Provider Demographics
NPI:1477523157
Name:ROGERS, RONALD P (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:P
Last Name:ROGERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 RUSSELL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:KY
Mailing Address - Zip Code:42728-1036
Mailing Address - Country:US
Mailing Address - Phone:270-384-5554
Mailing Address - Fax:270-924-9575
Practice Address - Street 1:920 RUSSELL RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:KY
Practice Address - Zip Code:42728-1036
Practice Address - Country:US
Practice Address - Phone:270-384-5554
Practice Address - Fax:270-924-9575
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3495111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85000271Medicaid
KY000000047150OtherBLUECARD PROGRAM
KY000000047150OtherBLUECARD PROGRAM
KY6017201Medicare ID - Type Unspecified