Provider Demographics
NPI:1477554897
Name:HOGARTH, JEAN-MAX (MD)
Entity Type:Individual
Prefix:
First Name:JEAN-MAX
Middle Name:
Last Name:HOGARTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1861 POWDER MILL ROAD
Mailing Address - Street 2:ATTN: MEDICAL STAFF OFFICE
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-4723
Mailing Address - Country:US
Mailing Address - Phone:717-718-2041
Mailing Address - Fax:
Practice Address - Street 1:1861 POWDER MILL RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-4723
Practice Address - Country:US
Practice Address - Phone:717-718-2000
Practice Address - Fax:717-718-3460
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0048287207L00000X
PAMD472951207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD286605600Medicaid