Provider Demographics
NPI:1093358459
Name:DR. JOHN A HOGG, OD PLLC
Entity Type:Organization
Organization Name:DR. JOHN A HOGG, OD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOGG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:260-414-5599
Mailing Address - Street 1:9012 132ND PL SE
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98059-3333
Mailing Address - Country:US
Mailing Address - Phone:260-414-5599
Mailing Address - Fax:
Practice Address - Street 1:50 E CARMEL DR
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-3301
Practice Address - Country:US
Practice Address - Phone:260-414-5599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty