Provider Demographics
NPI:1114182318
Name:VOGAN, DRUMMOND GRANT (MD)
Entity Type:Individual
Prefix:DR
First Name:DRUMMOND
Middle Name:GRANT
Last Name:VOGAN
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 1:4850 E BASELINE RD STE 107
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4626
Mailing Address - Country:US
Mailing Address - Phone:480-908-9892
Mailing Address - Fax:
Practice Address - Street 1:4850 E BASELINE RD STE 107
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4626
Practice Address - Country:US
Practice Address - Phone:480-908-9892
Practice Address - Fax:602-661-1189
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101246695207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine