Provider Demographics
NPI:1053309914
Name:VOGELGESANG, SCOTT A (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:A
Last Name:VOGELGESANG
Suffix:
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 1:200 HAWKINS DR
Mailing Address - Street 2:UNIVERSITY OF IOWA HOSPITALS & CLINICS
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-7725
Mailing Address - Fax:319-353-6290
Practice Address - Street 1:200 HAWKINS DR C 31 GH
Practice Address - Street 2:UNIVERSITY OF IOWA HOSPITALS & CLINICS
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-7725
Practice Address - Fax:319-353-6290
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA30928207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0134221Medicaid
IA52796OtherWELLMARK BCBS
G18536Medicare UPIN
IA52796Medicare PIN