Provider Demographics
NPI:1972802247
Name:RODGERS, LOUIS DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:DEAN
Last Name:RODGERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13138 CEDAR CREST LN.
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8751
Mailing Address - Country:US
Mailing Address - Phone:515-225-0822
Mailing Address - Fax:515-225-0822
Practice Address - Street 1:13138 CEDAR CREST LN.
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8751
Practice Address - Country:US
Practice Address - Phone:515-225-0822
Practice Address - Fax:515-225-0822
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA16382208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery