Provider Demographics
NPI:1841638392
Name:HOGAN HEALTHCARE CENTER PC
Entity type:Organization
Organization Name:HOGAN HEALTHCARE CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:GRAHM
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-456-5817
Mailing Address - Street 1:610 PEACHTREE PKWY STE 203
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-9762
Mailing Address - Country:US
Mailing Address - Phone:770-456-5817
Mailing Address - Fax:770-573-7203
Practice Address - Street 1:610 PEACHTREE PKWY STE 203
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-9762
Practice Address - Country:US
Practice Address - Phone:770-456-5817
Practice Address - Fax:770-573-7203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-06
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty