NPI 1649708090

Jesse Edward Rogers, PAC

Practitioner Physician Assistant Thomaston, GA

Practice location

Address: 801 W Gordon St, Thomaston, GA 30286-3426
Phone: (706) 647-8111
Mailing address: 195 Peachbelt Rd, Thomaston, GA 30286-4076

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 8346 (GA)

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Registry record

NPI: 1649708090
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 May 2017
Record last updated: 30 May 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.