Provider Demographics
NPI:1558343780
Name:ROGERS, WILLIAM SCOTT SR (DPM)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:ROGERS
Suffix:SR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5614 COTTAGE HILL RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-4211
Mailing Address - Country:US
Mailing Address - Phone:251-661-3332
Mailing Address - Fax:
Practice Address - Street 1:5614 COTTAGE HILL RD
Practice Address - Street 2:SUITE A
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-4211
Practice Address - Country:US
Practice Address - Phone:251-661-3332
Practice Address - Fax:251-661-3633
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL269213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL84-1640666OtherTIN
AL051520464ROGMedicare PIN
AL84-1640666OtherTIN
ALU99572Medicare UPIN