Provider Demographics
NPI:1831275197
Name:ROGERS, JOSEPH G (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:G
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 1:301 S 70TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2452
Mailing Address - Country:US
Mailing Address - Phone:402-483-7641
Mailing Address - Fax:402-483-0527
Practice Address - Street 1:301 S 70TH ST STE 200
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2452
Practice Address - Country:US
Practice Address - Phone:402-483-7641
Practice Address - Fax:402-483-0527
Is Sole Proprietor?:No
Enumeration Date:2006-10-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11602207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47-0546525-12Medicaid
D17326Medicare UPIN
NE47-0546525-12Medicaid