Provider Demographics
NPI:1942382478
Name:ROGERS, JOSEPH HANDLEY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:HANDLEY
Last Name:ROGERS
Suffix:JR
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 1:3940 MONTCLAIR RD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-2427
Mailing Address - Country:US
Mailing Address - Phone:205-871-4123
Mailing Address - Fax:205-871-4416
Practice Address - Street 1:3940 MONTCLAIR RD
Practice Address - Street 2:SUITE 404
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-2427
Practice Address - Country:US
Practice Address - Phone:205-871-4123
Practice Address - Fax:205-871-4416
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00005763208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC76836Medicare UPIN