Provider Demographics
NPI:1790786903
Name:VOGELSANG, STEVE T (MD)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:T
Last Name:VOGELSANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:117 CROSSFIELD DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-1982
Mailing Address - Country:US
Mailing Address - Phone:859-873-9188
Mailing Address - Fax:859-873-0870
Practice Address - Street 1:117 CROSSFIELD DR
Practice Address - Street 2:SUITE B
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-1982
Practice Address - Country:US
Practice Address - Phone:859-873-9188
Practice Address - Fax:859-873-0870
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY24177207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64241771Medicaid
KYK063780Medicare PIN
KY64241771Medicaid
F19662Medicare UPIN
1188307Medicare ID - Type Unspecified