1134196249 NPI number — GAYLON R. ROGERS MD, PC

Table of content: (NPI 1134196249)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134196249 NPI number — GAYLON R. ROGERS MD, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GAYLON R. ROGERS MD, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134196249
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2018 BROOKWOOD MEDICAL CENTER DRIVE
Provider Second Line Business Mailing Address:
PROFESSIONAL OFFICE BUILDING SUITE 315
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35209
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-877-2747
Provider Business Mailing Address Fax Number:
205-877-2526

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2018 BROOKWOOD MEDICAL CENTER DRIVE
Provider Second Line Business Practice Location Address:
PROFESSIONAL OFFICE BUILDING SUITE 315
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-877-2747
Provider Business Practice Location Address Fax Number:
205-877-2526
Provider Enumeration Date:
03/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LIVINGSTON
Authorized Official First Name:
CYNTHIA
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PRACTICE ADMINISTRATOR
Authorized Official Telephone Number:
205-877-2747

Provider Taxonomy Codes

  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000025139 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000025531 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 515-48812 . This is a "BCBS - UAB SURGERY" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 25531 . This is a "BCBS UAB WEST" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 515-44455 . This is a "BCBS - BROOKWOOD SURGERY" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 25139 . This is a "BCBS BROOKWOOD" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com