MEDICARE: JEFFREY GORDON HOGGARD M.D.

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	207RN0300X	Nephrology Physician	36102	NC

General Provider Information

NPI Number	:	1932101177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY GORDON HOGGARD M.D.

Provider Business Mailing Address
First Line	:	3700 BARRETT DR STE 200
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-7213
Country	:	US
Telephone Number	:	919-231-3966
Fax Number	:	919-231-3912

Provider Business Practice Location Address
First Line	:	3031 NEW BERN AVE STE 200
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-2989
Country	:	US
Telephone Number	:	919-747-7820
Fax Number	:

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	09/11/2024

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