Provider Demographics
NPI:1487833653
Name:ROBERT J. ROGERS,DC, PC
Entity Type:Organization
Organization Name:ROBERT J. ROGERS,DC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:616-794-3100
Mailing Address - Street 1:1439 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:BELDING
Mailing Address - State:MI
Mailing Address - Zip Code:48809-9288
Mailing Address - Country:US
Mailing Address - Phone:616-794-3100
Mailing Address - Fax:
Practice Address - Street 1:1439 W STATE ST
Practice Address - Street 2:
Practice Address - City:BELDING
Practice Address - State:MI
Practice Address - Zip Code:48809-9288
Practice Address - Country:US
Practice Address - Phone:616-794-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301002939111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIDD8579OtherRAILROAD MEDICARE
950C410440OtherBCBSM
MI144784357Medicaid
MIDD8579OtherRAILROAD MEDICARE