| Kenneth C. Rodgers, Ph.d., P.c. | |
|
8160 Highland Dr # 102 Sandy UT 84093-6492 | |
| (801) 943-3319 | |
| Not Available |
| Full Name | Kenneth C. Rodgers, Ph.d., P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 8160 Highland Dr, Sandy, Utah |
| Authorized Official Name and Position | Kenneth C. Rodgers (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8019433319 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth C. Rodgers, Ph.d., P.c. 8160 Highland Dr # 102 Sandy UT 84093-6492 Ph: (801) 943-3319 | Kenneth C. Rodgers, Ph.d., P.c. 8160 Highland Dr # 102 Sandy UT 84093-6492 Ph: (801) 943-3319 |
| NPI Number | 1841212727 |
|---|---|
| Provider Enumeration Date | 07/23/2006 |
| Last Update Date | 10/22/2007 |
| Medicare PECOS PAC ID | 8325215650 |
|---|---|
| Medicare Enrollment ID | O20120126000830 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841212727 | NPI | - | NPPES |
| 529563429016 | Medicaid | UT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1114662501 (Utah) | Primary |
| Provider Name | Kenneth C Rodgers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134306558 PECOS PAC ID: 5698942928 Enrollment ID: I20120126000843 |
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