Provider Demographics
NPI:1457570848
Name:MCEVER, RODGER PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:RODGER
Middle Name:PAUL
Last Name:MCEVER
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 1:825 NE 13TH ST
Mailing Address - Street 2:MS45
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5005
Mailing Address - Country:US
Mailing Address - Phone:405-271-6480
Mailing Address - Fax:405-271-3137
Practice Address - Street 1:825 NE 13TH ST
Practice Address - Street 2:MS45
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5005
Practice Address - Country:US
Practice Address - Phone:405-271-6480
Practice Address - Fax:405-271-3137
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK16359174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKB24736Medicare UPIN