Provider Demographics
NPI:1851313282
Name:VOGT, BETH A (MD)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:A
Last Name:VOGT
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 1:700 CHILDRENS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2664
Mailing Address - Country:US
Mailing Address - Phone:614-722-2000
Mailing Address - Fax:
Practice Address - Street 1:555 S 18TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2654
Practice Address - Country:US
Practice Address - Phone:614-722-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0669642080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH640090OtherCGS-MEDICARE
OH0117233Medicaid
OH000000526166OtherANTHEM
PA0018459780004Medicaid
OH0117233OtherBCMH
OH0651220OtherAETNA
OH364099OtherWELLCARE
OH0117233Medicaid
OH733543OtherBUCKEYE
OH000000221084OtherUNISON
OH364099OtherWELLCARE
OHVO0770981Medicare PIN