Provider Demographics
NPI:1134248859
Name:ROGERS, JOHN FLETCHER (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FLETCHER
Last Name:ROGERS
Suffix:
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 1:35 E ELIZABETH AVE
Mailing Address - Street 2:SUITE 25
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-6505
Mailing Address - Country:US
Mailing Address - Phone:610-865-9444
Mailing Address - Fax:610-865-9444
Practice Address - Street 1:35 E ELIZABETH AVE
Practice Address - Street 2:SUITE 25
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-6505
Practice Address - Country:US
Practice Address - Phone:610-865-9444
Practice Address - Fax:610-865-9444
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021532E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02577800OtherCAPITAL BLUE CROSS
PAC0000126651OtherUNITED AMERICAN
PAD71211Medicare UPIN
PAC0000126651OtherUNITED AMERICAN