Provider Demographics
NPI:1124881560
Name:RODGERS, JAMES ALVIN II
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALVIN
Last Name:RODGERS
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2771 RANDOLPH ST NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44485-2520
Mailing Address - Country:US
Mailing Address - Phone:330-984-8285
Mailing Address - Fax:
Practice Address - Street 1:2771 RANDOLPH ST NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44485-2520
Practice Address - Country:US
Practice Address - Phone:330-984-8285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator