Provider Demographics
NPI:1366631418
Name:HOGUE CHIROPRACTIC
Entity Type:Organization
Organization Name:HOGUE CHIROPRACTIC
Other - Org Name:RICHARD P. HOGUE, DC PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:HOGUE
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:864-232-1111
Mailing Address - Street 1:140 W STONE AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-5524
Mailing Address - Country:US
Mailing Address - Phone:864-232-1111
Mailing Address - Fax:864-242-9172
Practice Address - Street 1:140 W STONE AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-5524
Practice Address - Country:US
Practice Address - Phone:864-232-1111
Practice Address - Fax:864-242-9172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1062111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGCH475Medicaid