Provider Demographics
NPI:1386742757
Name:ROGERS, JOCELYN DESHUN (MD)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:DESHUN
Last Name:ROGERS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:836 E 65TH ST STE 22
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4493
Mailing Address - Country:US
Mailing Address - Phone:912-819-7171
Mailing Address - Fax:912-691-9287
Practice Address - Street 1:5354 REYNOLDS ST STE 422
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405
Practice Address - Country:US
Practice Address - Phone:912-354-2634
Practice Address - Fax:912-354-8375
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058000207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA562465716AMedicaid