Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1707 | OH |
Y | 222Z00000X | Podiatrist | 1707 | OH |
NPI | 1023004991 |
---|---|
Provider Name | Dr. William R Hogan |
First Address | Cincinnati, OH 45238-5214 |
Second Address | Cincinnati, OH 45238-5214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2005 |
Last Update Date | 17/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000012371 | BLUE CROSS/BLUE SHIELD (01) | OH |
0318043 | (05) | OH |
1287600001 | MEDICARE DURABLE ID NUMBE (01) | OH |
27000546 | UNITED HEALTHCARE (01) | OH |
27-00262 | EVERCARE,UNITEDHELATHCARE (01) | OH |
311164051 00 | WORKERS COMPENSATION (01) | OH |
648840 | AETNA (01) | OH |
T80417 | (02) | OH |