Provider Demographics
NPI:1760559066
Name:ROGERS, RICHARD LLOYD (BC-HIS)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:LLOYD
Last Name:ROGERS
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-7220
Mailing Address - Country:US
Mailing Address - Phone:541-772-4365
Mailing Address - Fax:541-773-5628
Practice Address - Street 1:42 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-7220
Practice Address - Country:US
Practice Address - Phone:541-772-4365
Practice Address - Fax:541-773-5628
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORHAS671889237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist