Provider Demographics
NPI:1164432613
Name:HOGANCAMP, WILLIAM E (MD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:E
Last Name:HOGANCAMP
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:PO BOX 636961
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6961
Mailing Address - Country:US
Mailing Address - Phone:513-981-5130
Mailing Address - Fax:513-981-5015
Practice Address - Street 1:1532 LONE OAK RD
Practice Address - Street 2:SUITE 150
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-7913
Practice Address - Country:US
Practice Address - Phone:270-538-6700
Practice Address - Fax:270-538-6755
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY32561174400000X, 2084S0012X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No174400000XOther Service ProvidersSpecialist
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64325616Medicaid
KYK115652Medicare PIN
KY64325616Medicaid
KY05156OtherRAILROAD MEDICARE GROUP #
KY9060OtherMEDICARE GROUP #
KY9372501OtherMEDICARE
KY0906001Medicare ID - Type Unspecified
KY65940652OtherMEDICAID GROUP #
KYF44924Medicare UPIN
KY5316100002OtherMEDICARE DME
KYP00110715OtherRAILROAD MEDICARE #
KY64325616Medicaid