Provider Demographics
NPI:1821057696
Name:HOGIN, JAMES WALTON (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WALTON
Last Name:HOGIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6510 S WESTERN AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-1712
Mailing Address - Country:US
Mailing Address - Phone:405-634-5400
Mailing Address - Fax:405-634-5174
Practice Address - Street 1:6510 S WESTERN AVE
Practice Address - Street 2:STE 100
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-1712
Practice Address - Country:US
Practice Address - Phone:405-634-5400
Practice Address - Fax:405-634-5174
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK1714207R00000X, 204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK241406902Medicare PIN
OKD38547Medicare UPIN