Provider Demographics
NPI:1710174610
Name:HOGUE CHIROPRACTIC CENTER PLLC
Entity Type:Organization
Organization Name:HOGUE CHIROPRACTIC CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:HOGUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-341-7746
Mailing Address - Street 1:174 BARNWOOD DR.
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017-2501
Mailing Address - Country:US
Mailing Address - Phone:859-341-7746
Mailing Address - Fax:859-341-4214
Practice Address - Street 1:174 BARNWOOD DR
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-2501
Practice Address - Country:US
Practice Address - Phone:859-341-7746
Practice Address - Fax:859-341-4214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4644111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY9469OtherMEDICARE GROUP NUMBER
KY0946901Medicare PIN