Provider Demographics
NPI:1396770020
Name:VOGEL, HARLE LAUREN (DO)
Entity type:Individual
Prefix:DR
First Name:HARLE
Middle Name:LAUREN
Last Name:VOGEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 LANE 230 JIMMERSON LK
Mailing Address - Street 2:
Mailing Address - City:ANGOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46703-9493
Mailing Address - Country:US
Mailing Address - Phone:260-316-6222
Mailing Address - Fax:
Practice Address - Street 1:315 LANE 230 JIMMERSON LK
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:IN
Practice Address - Zip Code:46703-9493
Practice Address - Country:US
Practice Address - Phone:260-316-6222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02005319A207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0130246OtherPHP/IBA
MI990005530OtherRAILROAD MEDICARE
MI1231660OtherPHP/IBA
MI3246247Medicaid
MI3206386Medicaid
MI3551200044OtherBCBSM PIN
MI1231660OtherPHP/IBA
MI0A26057041Medicare PIN