Provider Demographics
NPI:1326144981
Name:HOGAN, CHRISTOPHER DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DEAN
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:PO BOX 240527
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99524-0527
Mailing Address - Country:US
Mailing Address - Phone:907-561-4421
Mailing Address - Fax:907-929-9494
Practice Address - Street 1:4141 B ST STE 407
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5944
Practice Address - Country:US
Practice Address - Phone:907-561-4421
Practice Address - Fax:907-561-5257
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK314111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCHO3311Medicaid
AKK153124OtherMEDICARE GROUP PIN #
AKK153126OtherMEDICARE PROVIDER NUMBER
AK92-0088528OtherTAX ID NUMBER
AKU99165Medicare UPIN