Provider Demographics
NPI:1760591820
Name:HOGG, RONALD J (MD)
Entity Type:Individual
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First Name:RONALD
Middle Name:J
Last Name:HOGG
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3200 N CENTRAL AVE
Mailing Address - Street 2:SUITE 900
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2425
Mailing Address - Country:US
Mailing Address - Phone:602-406-3729
Mailing Address - Fax:602-798-9412
Practice Address - Street 1:222 W THOMAS RD
Practice Address - Street 2:SUITE 410
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4419
Practice Address - Country:US
Practice Address - Phone:602-406-6094
Practice Address - Fax:602-406-4176
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
AZ340922080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ939514Medicaid
AZC17010Medicare UPIN
AZ939514Medicaid