Provider Demographics
NPI:1518098516
Name:VOGEL, JOHN PATRICK
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PATRICK
Last Name:VOGEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 W OAKRIDGE PARK
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-4020
Mailing Address - Country:US
Mailing Address - Phone:504-833-5773
Mailing Address - Fax:504-837-8812
Practice Address - Street 1:433 METAIRIE RD
Practice Address - Street 2:SUITE #220
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4333
Practice Address - Country:US
Practice Address - Phone:504-833-5773
Practice Address - Fax:504-837-8812
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA454103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5S488Medicare ID - Type Unspecified