Provider Demographics
NPI:1972569507
Name:ROGERS, DAVID L (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:ROGERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2810 N SWAN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6305
Mailing Address - Country:US
Mailing Address - Phone:520-324-2030
Mailing Address - Fax:520-324-2619
Practice Address - Street 1:2810 N SWAN RD STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6300
Practice Address - Country:US
Practice Address - Phone:520-324-2030
Practice Address - Fax:520-445-2619
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18073207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ285876Medicaid
E28401Medicare UPIN
AZ285876Medicaid