Provider Demographics
NPI:1134196249
Name:GAYLON R. ROGERS MD, PC
Entity type:Organization
Organization Name:GAYLON R. ROGERS MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:LIVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:CMC
Authorized Official - Phone:205-877-2747
Mailing Address - Street 1:2018 BROOKWOOD MEDICAL CENTER DRIVE
Mailing Address - Street 2:PROFESSIONAL OFFICE BUILDING SUITE 315
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209
Mailing Address - Country:US
Mailing Address - Phone:205-877-2747
Mailing Address - Fax:205-877-2526
Practice Address - Street 1:2018 BROOKWOOD MEDICAL CENTER DRIVE
Practice Address - Street 2:PROFESSIONAL OFFICE BUILDING SUITE 315
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209
Practice Address - Country:US
Practice Address - Phone:205-877-2747
Practice Address - Fax:205-877-2526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000025139Medicaid
AL000025531Medicaid
AL515-48812OtherBCBS - UAB SURGERY
AL25531OtherBCBS UAB WEST
AL515-44455OtherBCBS - BROOKWOOD SURGERY
AL25139OtherBCBS BROOKWOOD
AL515-48812OtherBCBS - UAB SURGERY
AL000025139Medicare PIN
ALC049Medicare PIN
AL515-44455OtherBCBS - BROOKWOOD SURGERY
ALD08194Medicare UPIN