Provider Demographics
NPI:1679186068
Name:HOGUE, CHRISTOPHER BROOKS II
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BROOKS
Last Name:HOGUE
Suffix:II
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 1:385 VERSAILLES RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-3646
Mailing Address - Country:US
Mailing Address - Phone:502-695-7364
Mailing Address - Fax:502-695-7382
Practice Address - Street 1:385 VERSAILLES RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-3646
Practice Address - Country:US
Practice Address - Phone:502-695-7364
Practice Address - Fax:502-695-7382
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP07118183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist