Provider Demographics
NPI:1831296284
Name:HOGGATT, MICHELE L (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:L
Last Name:HOGGATT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2009 MICCOSUKEE RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5359
Mailing Address - Country:US
Mailing Address - Phone:850-656-2128
Mailing Address - Fax:850-942-0322
Practice Address - Street 1:2009 MICCOSUKEE RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5359
Practice Address - Country:US
Practice Address - Phone:850-656-2128
Practice Address - Fax:850-942-0322
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME96807207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI13432Medicare UPIN