Provider Demographics
NPI:1942483110
Name:ROGERS, HANS WILLIAM (DPH)
Entity Type:Individual
Prefix:
First Name:HANS
Middle Name:WILLIAM
Last Name:ROGERS
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 FALLBERRY ST
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-3005
Mailing Address - Country:US
Mailing Address - Phone:865-482-7478
Mailing Address - Fax:
Practice Address - Street 1:103 N GATEWAY AVE
Practice Address - Street 2:
Practice Address - City:ROCKWOOD
Practice Address - State:TN
Practice Address - Zip Code:37854-2330
Practice Address - Country:US
Practice Address - Phone:865-354-3422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist