Provider Demographics
NPI:1215968599
Name:VOGLER, CAROLYN (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:
Last Name:VOGLER
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 1:314 S.SCHOOL STREET
Mailing Address - Street 2:P.O. BOX 227
Mailing Address - City:DERMOTT
Mailing Address - State:AR
Mailing Address - Zip Code:71638
Mailing Address - Country:US
Mailing Address - Phone:870-538-4727
Mailing Address - Fax:
Practice Address - Street 1:314 S SCHOOL ST
Practice Address - Street 2:
Practice Address - City:DERMOTT
Practice Address - State:AR
Practice Address - Zip Code:71638-2127
Practice Address - Country:US
Practice Address - Phone:870-538-4727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-3872208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR154472001Medicaid
ARI08452Medicare UPIN
AR5M955Medicare ID - Type Unspecified