Provider Demographics
NPI:1558367466
Name:SEARFOSS, RODGER C (MD)
Entity Type:Individual
Prefix:DR
First Name:RODGER
Middle Name:C
Last Name:SEARFOSS
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 1:325 OLD AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601
Mailing Address - Country:US
Mailing Address - Phone:724-836-8787
Mailing Address - Fax:
Practice Address - Street 1:911 LIGONIER ST
Practice Address - Street 2:STE 003
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1805
Practice Address - Country:US
Practice Address - Phone:724-537-5594
Practice Address - Fax:724-537-9712
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD017315E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0588580Medicaid
PAB39267Medicare UPIN
PA141922Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER