MEDICARE: DR. JEFFREY D HOGGE DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	1200305	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0245660001	OTHER	KS	NSC

General Provider Information

NPI Number	:	1578654604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY D HOGGE DPM

Provider Business Mailing Address
First Line	:	209 N 6TH ST
Second Line	:	PO BOX 372
City	:	INDEPENDENCE
State	:	KS
Zip	:	67301-3100
Country	:	US
Telephone Number	:	620-331-1840
Fax Number	:	620-331-7530

Provider Business Practice Location Address
First Line	:	209 N 6TH ST
Second Line	:
City	:	INDEPENDENCE
State	:	KS
Zip	:	67301-3100
Country	:	US
Telephone Number	:	620-331-1840
Fax Number	:	620-331-7530

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	11/14/2007

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