Basic Information
| Provider Information | |||||||||
| NPI: | 1750456703 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROGERS | ||||||||
| FirstName: | ALAN | ||||||||
| MiddleName: | SCOTT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 530-A HARKLE ROAD | ||||||||
| Address2: | |||||||||
| City: | SANTA FE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 87505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5059836911 | ||||||||
| FaxNumber: | 5059837212 | ||||||||
| Practice Location | |||||||||
| Address1: | 530 HARKLE RD STE A | ||||||||
| Address2: | |||||||||
| City: | SANTA FE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 875054713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5059836911 | ||||||||
| FaxNumber: | 5059837212 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 87-279 | NM | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.