Provider Demographics
NPI:1578932695
Name:HOGGARD, LUCAS J (APRN)
Entity Type:Individual
Prefix:
First Name:LUCAS
Middle Name:J
Last Name:HOGGARD
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9146 HIGHWAY 63 N
Mailing Address - Street 2:
Mailing Address - City:BONO
Mailing Address - State:AR
Mailing Address - Zip Code:72416-8153
Mailing Address - Country:US
Mailing Address - Phone:870-930-9990
Mailing Address - Fax:870-930-9992
Practice Address - Street 1:1045 W MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:WALNUT RIDGE
Practice Address - State:AR
Practice Address - Zip Code:72476
Practice Address - Country:US
Practice Address - Phone:870-930-9990
Practice Address - Fax:870-930-9992
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2018-08-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARA004534363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner