Provider Demographics
NPI:1225276801
Name:HOGAN, JAMES CAMERON (PA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CAMERON
Last Name:HOGAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:POST BOX 268947
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73126-8947
Mailing Address - Country:US
Mailing Address - Phone:405-947-8586
Mailing Address - Fax:405-948-6507
Practice Address - Street 1:401 WEST BOWMAN
Practice Address - Street 2:
Practice Address - City:KINGFISHER
Practice Address - State:OK
Practice Address - Zip Code:73750
Practice Address - Country:US
Practice Address - Phone:405-375-7935
Practice Address - Fax:405-948-6507
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant