Provider Demographics
NPI:1841234754
Name:HOGUE, RICHARD P JR (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:P
Last Name:HOGUE
Suffix:JR
Gender:M
Credentials:DC
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 2282
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29602-2282
Mailing Address - Country:US
Mailing Address - Phone:864-232-1111
Mailing Address - Fax:864-242-9172
Practice Address - Street 1:140 WEST STONE AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609
Practice Address - Country:US
Practice Address - Phone:864-232-1111
Practice Address - Fax:864-242-9172
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1062111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGCH475Medicaid
SCGCH475Medicaid