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Dr. Roger Dale Paige
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NPI Number Detailed Information
Provider Information:
| Name: | Dr. Roger Dale Paige |
| Gender: | M |
| Provider License Number If Given: | 116659 |
NPI Information:
| NPI: | 1770582280 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 7/18/2005 |
| Last Update Date: | 4/22/2014 |
Provider Business Mailing Address:
| Address: | 1230 N DUQUESNE RD Joplin, MO 64801 |
| Phone Number: | 4177821443 |
| Fax Number: | 4177823240 |
Provider Business Practice Location Address:
| Address: | 1230 N DUQUESNE RD Joplin, MO 64801 |
| Phone Number: | 4177821443 |
| Fax Number: | 4177823240 |
Provider Taxonomy:
| Primary: | 103TC0700X |
| Secondary (if any): | |
| State: | MO |
