Provider Demographics
NPI:1952425431
Name:ROGERS, STEVEN L (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:L
Last Name:ROGERS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4403 KAREN DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45042-3811
Mailing Address - Country:US
Mailing Address - Phone:513-424-8554
Mailing Address - Fax:
Practice Address - Street 1:2700 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:SUITE 850
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-3738
Practice Address - Country:US
Practice Address - Phone:937-439-1020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3142152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHR00475651Medicare ID - Type Unspecified
OHT47122Medicare UPIN