Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 0418813 | KS |
Y | 208600000X | Surgeon | 0418813 | KS |
NPI | 1013985985 |
---|---|
Provider Name | Paul F Bogner |
First Address | Newton, KS 67114-9017 |
Second Address | Newton, KS 67114-9017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 14/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100205180F | (05) | KS |
111178029 | PTAN (01) | KS |
AB9336199 | DEA (01) | |
B91257 | (02) |