Provider Demographics
NPI:1740325802
Name:HOGAN, CHRISTOPHER A (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:A
Last Name:HOGAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5949 BUFORD HWY STE 106
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-2439
Mailing Address - Country:US
Mailing Address - Phone:678-646-0401
Mailing Address - Fax:678-966-9300
Practice Address - Street 1:5949 BUFORD HWY STE 106
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-2439
Practice Address - Country:US
Practice Address - Phone:678-646-0401
Practice Address - Fax:678-966-9300
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007478111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52053663006OtherBCBS OF GA
GAU98760Medicare UPIN
GA52053663006OtherBCBS OF GA