Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 27338 | CO |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 27338 | CO |
NPI | 1689669970 |
---|---|
Provider Name | Gregory Allen Hogle |
First Address | Denver, CO 80220-4020 |
Second Address | Denver, CO 80220-4020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 31/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01273382 | (05) | CA |
D28410 | (02) |