Provider Demographics
NPI:1184740961
Name:HOGIN MEDICAL CENTER PC
Entity type:Organization
Organization Name:HOGIN MEDICAL CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WALTON
Authorized Official - Last Name:HOGIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:405-631-0524
Mailing Address - Street 1:937 SW 89TH ST
Mailing Address - Street 2:STE C
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-9231
Mailing Address - Country:US
Mailing Address - Phone:405-631-0524
Mailing Address - Fax:405-631-9465
Practice Address - Street 1:937 SW 89TH ST
Practice Address - Street 2:STE C
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-9231
Practice Address - Country:US
Practice Address - Phone:405-631-0524
Practice Address - Fax:405-631-9465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100741930AMedicaid
OK100522075Medicare PIN
OK100741930AMedicaid