Provider Demographics
NPI:1801408190
Name:HOGAN, ANTHONY R (CAA)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:R
Last Name:HOGAN
Suffix:
Gender:M
Credentials:CAA
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:545 MADISON TRL
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44230-9626
Mailing Address - Country:US
Mailing Address - Phone:330-603-2446
Mailing Address - Fax:
Practice Address - Street 1:100 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45502-1312
Practice Address - Country:US
Practice Address - Phone:937-521-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant