Provider Demographics
NPI:1457969255
Name:HOGUE, PAUL (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:HOGUE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CYNTHIA ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-3711
Mailing Address - Country:US
Mailing Address - Phone:601-924-4444
Mailing Address - Fax:601-924-5471
Practice Address - Street 1:115 CYNTHIA ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-3711
Practice Address - Country:US
Practice Address - Phone:601-924-4444
Practice Address - Fax:601-924-5471
Is Sole Proprietor?:No
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1011152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist