Provider Demographics
NPI:1639189590
Name:HOGAN, JAMES E (RPA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:HOGAN
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MEDICAL CENTER LOOP
Mailing Address - Street 2:
Mailing Address - City:VINALHAVEN
Mailing Address - State:ME
Mailing Address - Zip Code:04863-4119
Mailing Address - Country:US
Mailing Address - Phone:207-863-4341
Mailing Address - Fax:207-863-2737
Practice Address - Street 1:15 MEDICAL CENTER LOOP
Practice Address - Street 2:
Practice Address - City:VINALHAVEN
Practice Address - State:ME
Practice Address - Zip Code:04863
Practice Address - Country:US
Practice Address - Phone:207-863-4341
Practice Address - Fax:207-863-2737
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S43420Medicare UPIN