Provider Demographics
NPI:1770599516
Name:VOGAN, CLIFFORD RAYMOND (MD)
Entity type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:RAYMOND
Last Name:VOGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:882 E BRADY RD
Mailing Address - Street 2:COWANSVILLE AREA HEALTH CENTER
Mailing Address - City:COWANSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16218-1316
Mailing Address - Country:US
Mailing Address - Phone:724-548-5605
Mailing Address - Fax:724-543-7425
Practice Address - Street 1:1 NOLTE DR
Practice Address - Street 2:ARMSTRONG COUNTY MEMORIAL HOSPITAL
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-7111
Practice Address - Country:US
Practice Address - Phone:724-543-8109
Practice Address - Fax:724-543-8809
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021896E207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006962650006Medicaid
PA0006962650006Medicaid
PAB35799Medicare UPIN