Provider Demographics
NPI:1679709299
Name:DELAPPE, ROGER S JR (MD)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:S
Last Name:DELAPPE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3845
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30914-3845
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4350 TOWNE CENTRE DR
Practice Address - Street 2:SUITE 1000
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3301
Practice Address - Country:US
Practice Address - Phone:706-868-3940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0733642085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology