Provider Demographics
NPI:1851589832
Name:DR ROGAN & ASSOCIATES PC
Entity Type:Organization
Organization Name:DR ROGAN & ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:ROGAN
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:812-547-1377
Mailing Address - Street 1:8475 DAUBY LN
Mailing Address - Street 2:
Mailing Address - City:TELL CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47586-8346
Mailing Address - Country:US
Mailing Address - Phone:812-547-1377
Mailing Address - Fax:812-547-3695
Practice Address - Street 1:8475 DAUBY LN
Practice Address - Street 2:
Practice Address - City:TELL CITY
Practice Address - State:IN
Practice Address - Zip Code:47586-8346
Practice Address - Country:US
Practice Address - Phone:812-547-1377
Practice Address - Fax:812-547-3695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000190729OtherANTHEM
IN1020502720Medicaid