Provider Demographics
NPI:1942314810
Name:ROGERS, SCOTT F (PA-C)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:F
Last Name:ROGERS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 662 108 S. MAIN ST
Mailing Address - Street 2:LENNOX AREA MEDICAL CENTER
Mailing Address - City:LENNOX
Mailing Address - State:SD
Mailing Address - Zip Code:57039-0662
Mailing Address - Country:US
Mailing Address - Phone:605-647-2841
Mailing Address - Fax:605-647-2843
Practice Address - Street 1:108 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LENNOX
Practice Address - State:SD
Practice Address - Zip Code:57039-0662
Practice Address - Country:US
Practice Address - Phone:605-647-2841
Practice Address - Fax:605-647-2843
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0059207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine