Provider Demographics
NPI:1245395623
Name:HOGLE, DAVID M (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:HOGLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1995 ERRECART BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-8336
Mailing Address - Country:US
Mailing Address - Phone:775-777-0216
Mailing Address - Fax:775-778-6728
Practice Address - Street 1:1995 ERRECART BLVD STE 103
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-8336
Practice Address - Country:US
Practice Address - Phone:775-738-3111
Practice Address - Fax:775-778-6728
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV3967207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV3967OtherSTATE LICENSE
NV002004353Medicaid
NVCS03084OtherSTATE PHARMACY
NVCS03084OtherSTATE PHARMACY
NVCS03084OtherSTATE PHARMACY