Provider Demographics
NPI:1184698110
Name:ROGERS, JOHN W (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:ROGERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2013 JEFFERSON ST SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-2419
Mailing Address - Country:US
Mailing Address - Phone:540-982-0237
Mailing Address - Fax:540-982-0103
Practice Address - Street 1:1900 ELECTRIC RD
Practice Address - Street 2:RADIATON ONCOLOGY
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7474
Practice Address - Country:US
Practice Address - Phone:540-774-8660
Practice Address - Fax:540-776-4736
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01012365552085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00196715OtherMEDICARE RAILROAD
I05715Medicare UPIN