Provider Demographics
NPI:1265452668
Name:HOGAN, DEBORAH L (MD)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:HOGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:699 GALLATIN ST
Mailing Address - Street 2:STE B-1
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801
Mailing Address - Country:US
Mailing Address - Phone:256-536-9255
Mailing Address - Fax:256-536-9288
Practice Address - Street 1:699 GALLATIN ST
Practice Address - Street 2:STE B-1
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-536-9255
Practice Address - Fax:256-536-9288
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALAL146022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL89905OtherBC
AL89905OtherBC