Provider Demographics
NPI:1861446684
Name:ROGERS, NICHOLAS ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ALAN
Last Name:ROGERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2250 N BANK DR
Mailing Address - Street 2:
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43220-5420
Mailing Address - Country:US
Mailing Address - Phone:614-451-7550
Mailing Address - Fax:614-451-8642
Practice Address - Street 1:2250 N BANK DR
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43220-5420
Practice Address - Country:US
Practice Address - Phone:614-451-7550
Practice Address - Fax:614-451-8642
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.087365207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2653105Medicaid
OH000000476929OtherANTHEM BC BS
OH375700981001OtherMEDICAL MUTUAL
OH35087365OtherMEDICAL LICENSE
OHP00311798OtherRAILROAD MEDICARE
OH0351310001OtherDMERC REGION B
OH35087365OtherMEDICAL LICENSE
OH375700981001OtherMEDICAL MUTUAL
OHI52982Medicare UPIN