Provider Demographics
NPI:1235277658
Name:HOGAN, WILLIAM KENNETH (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:KENNETH
Last Name:HOGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 W TRENTON AVE
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19067-6651
Mailing Address - Country:US
Mailing Address - Phone:215-295-7012
Mailing Address - Fax:215-295-6191
Practice Address - Street 1:97 W TRENTON AVE
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:PA
Practice Address - Zip Code:19067-6651
Practice Address - Country:US
Practice Address - Phone:215-295-7012
Practice Address - Fax:215-295-6191
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005503L111N00000X
NJMC 02551111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU10448Medicare UPIN
PA452443Medicare ID - Type Unspecified