Provider Demographics
NPI:1669797999
Name:ROGELIO ESCARCEGA M.D., P.C.
Entity type:Organization
Organization Name:ROGELIO ESCARCEGA M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGELIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCARCEGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-885-4500
Mailing Address - Street 1:1720 E REELFOOT AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-6047
Mailing Address - Country:US
Mailing Address - Phone:731-885-4500
Mailing Address - Fax:731-885-1838
Practice Address - Street 1:1720 E REELFOOT AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-6047
Practice Address - Country:US
Practice Address - Phone:731-885-4500
Practice Address - Fax:731-885-1838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD10159174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3162400Medicare PIN
TNB59289Medicare UPIN