Provider Demographics
NPI:1831126044
Name:VOGHT, ANN M (PA-C)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:VOGHT
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:9250 N 3RD ST
Mailing Address - Street 2:SUITE 4010
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2437
Mailing Address - Country:US
Mailing Address - Phone:602-633-3848
Mailing Address - Fax:602-633-3841
Practice Address - Street 1:14415 W MCDOWELL RD
Practice Address - Street 2:SUITE D102
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2521
Practice Address - Country:US
Practice Address - Phone:602-633-3848
Practice Address - Fax:602-633-3841
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2013-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN10000488A363AM0700X
AZ5462363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP25035Medicare UPIN
IN176470BBMedicare ID - Type Unspecified