Provider Demographics
NPI:1174596944
Name:ROGERS, JAMES J (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:ROGERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 GRANDE BLVD
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-3242
Mailing Address - Country:US
Mailing Address - Phone:856-520-9951
Mailing Address - Fax:
Practice Address - Street 1:100 CENTURY PKWY STE 350
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1149
Practice Address - Country:US
Practice Address - Phone:856-482-9000
Practice Address - Fax:856-482-1159
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB058523002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8406804Medicaid
NJ8406804Medicaid
NJ8406804Medicaid