Provider Demographics
NPI:1124217732
Name:HOGUE, PATRICIA A (PHD, PA-C)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:A
Last Name:HOGUE
Suffix:
Gender:F
Credentials:PHD, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 ARLINGTON AVE
Mailing Address - Street 2:UT PHYSICIAN GROUP
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2595
Mailing Address - Country:US
Mailing Address - Phone:419-383-7150
Mailing Address - Fax:419-383-5880
Practice Address - Street 1:3000 ARLINGTON AVE
Practice Address - Street 2:UT PHYSICIAN GROUP
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2595
Practice Address - Country:US
Practice Address - Phone:419-383-7150
Practice Address - Fax:419-383-5880
Is Sole Proprietor?:No
Enumeration Date:2007-10-19
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50000428363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH50000428OtherLICENSE