Provider Demographics
NPI:1780638700
Name:VOGLER, TIMOTHY ALFRED (DPM)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:ALFRED
Last Name:VOGLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:336-277-6550
Mailing Address - Fax:336-768-1026
Practice Address - Street 1:3641 WESTGATE CENTER CIR STE A
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2936
Practice Address - Country:US
Practice Address - Phone:336-277-6550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC293213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1780638700Medicaid
NC1212660025OtherDME - ASHEBORO FOOT & ANK
NC121266024OtherDME - FAMILY FOOT & ANKLE
NC890800MMedicaid
NC2433127BMedicare ID - Type Unspecified
NC121266024OtherDME - FAMILY FOOT & ANKLE
NC890800MMedicaid