Provider Demographics
NPI:1184683898
Name:WILLIAM F VOGENITZ MD
Entity Type:Organization
Organization Name:WILLIAM F VOGENITZ MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:VOGENITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-716-2662
Mailing Address - Street 1:P O BOX 504903
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-4903
Mailing Address - Country:US
Mailing Address - Phone:864-716-2662
Mailing Address - Fax:817-716-2627
Practice Address - Street 1:1 SPRINGBACK WAY
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621
Practice Address - Country:US
Practice Address - Phone:864-716-2662
Practice Address - Fax:817-716-2627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-21
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE0898Medicare PIN
SCGP3909Medicaid
SC8287Medicare PIN