Provider Demographics
NPI:1922062363
Name:ROGERS, HOWARD GARY (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:GARY
Last Name:ROGERS
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:P.O. BOX 235019
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36123-5019
Mailing Address - Country:US
Mailing Address - Phone:800-232-5703
Mailing Address - Fax:334-395-4110
Practice Address - Street 1:2122 MANCHESTER EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904
Practice Address - Country:US
Practice Address - Phone:800-232-5703
Practice Address - Fax:334-395-4110
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030203207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000354153BMedicaid
GA450991OtherBCBS
GA450991OtherBCBS
GA000354153BMedicaid
GAD42143Medicare UPIN