Provider Demographics
NPI:1528296563
Name:ROGERS, ALECIA W (OD)
Entity type:Individual
Prefix:DR
First Name:ALECIA
Middle Name:W
Last Name:ROGERS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 COLUMBIANA CIR STE 1154
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-2266
Mailing Address - Country:US
Mailing Address - Phone:803-781-1669
Mailing Address - Fax:
Practice Address - Street 1:100 COLUMBIANA CIR STE 1154
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-2266
Practice Address - Country:US
Practice Address - Phone:803-781-1669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2874152W00000X
SC1833152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist